Application of blood glucose spectrum and insulin secretion curve in rational selection of insulin secretagogues for type 2 diabetes
Objective To explore the value of insulin secretion curve and blood glucose spectrum in the selection of insulin secretagogues for type 2 diabetes,and to provide a basis for clinical selection of insulin secretagogues.Methods One hundred and twenty patients with type 2 diabetes who selected insulin secretagogues according to the need of hypoglycemic treatment at Dongying Second People's Hospital were selected for the randomized controlled trial.They were divided into an observation group and a control group by the random number table method,with 60 cases in each group.There were 38 males and 22 females in the observation group;they were(58.27±6.34)years old,with a course of disease of(3.62±1.28)years.There were 33 males and 27 females in the control group;they were(59.04±7.82)years old,with a course of disease of(3.55± 1.17)years.The observation group carried out the Mantou meal test and selected the insulin secretagogues sulfonylurea(glimepiride and gliclazide)and glinide(repaglinide)according to the insulin secretion curve.The control group selected the insulin secretagogues according to the blood glucose spectrum.Both groups were treated for 24 weeks.The average days of blood glucose control reaching the standard,the rate of blood glucose reaching the standard,the days of hospitalization,and the incidences of hypoglycemia in the two groups were recorded.The insulin β cell function[fasting insulin(FINS),insulin resistance index(HOMA-IR),and C-peptide(CP)]and blood glucose levels[fasting blood glucose(FPG),2 h postprandial blood glucose(2 h PBG),and glycosylated hemoglobin(HbA1c)]before and after the treatment were compared between the two groups.t and x2 tests were applied.Results The average days of blood glucose control reaching the standard and hospitalization days in the observation group were shorter than those in the control group[(7.05± 1.42)d vs.(8.39±1.86)d and(10.29±2.08)d vs.(11.35±2.17)d];the rate of blood glucose reaching the standard in the observation group was higher than that in the control group[86.67％(52/60)vs.71.67％(43/60)];there were statistical differences(t=4.436,2.732,x2=4.093;all P＜0.05).After the treatment,the levels of FINS and CP in the observation group were higher than those in the control group[9.32±1.55)IU/L vs.(8.46±1.38)IU/L and(1.49±0.39)μg/L vs.(1.35±0.32)μg/L];the HOMA-IR in the observation group was lower than that in the control group[(1.92±0.43)vs.(2.37± 0.84)];there were statistical differences(t=3.210,2.150,and 3.694;all P＜0.05).After the treatment,the levels of FPG,2 h PBG,and HbA1c in the observation group were lower than those in the control group[(6.47±1.12)mmol/L vs.(7.35±0.94)mmol/L,(10.52±1.17)mmol/L vs.(11.83±1.59)mmol/L,and(6.12±1.09)％vs.(6.79±1.35)％],with statistical differences(t=4.662,5.140,and 2.991;all P＜0.05).There was no statistical difference in the incidence of adverse reactions between the observation group and the control group[15.00(9/60)vs.18.33(11/60);x2=0.240;P=0.624].Conclusion Compared with by the blood glucose spectrum,the insulin secretagogue selected by the insulin secretion curve has better insulin secretion promoting and hypoglycemic effects,and is conducive to shortening the time of blood glucose control reaching the standard and hospitalization and improving the rate of blood glucose reaching the standard.
Type 2 diabetesInsulin secretion curveBlood glucose spectrumCurative effect
万方数据
维普
