目的 观察罗格列酮联合胰岛素治疗对单用胰岛素控制不佳的肥胖2型糖尿病(type 2 diabetes mellitus，T2DM)患者血糖飘移的影响。方法 将单用胰岛素控制不佳的肥胖T2DM患者106例作为研究对象，用随机数字表法分为2组。对照组继续给予胰岛素治疗，观察组在对照组治疗的基础上予以罗格列酮，比较治疗前后2组患者空腹血糖(fasting blood glucose，FBG)、餐后2 h血糖(2 hours postprandial blood glucose，2 hBG)、糖化血红蛋白(glycosylated hemoglobin，HbA1c)、三酰甘油(triglycerides，TG)、总胆固醇(total cholesterol，TC)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol，LDL-C)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol，HDL-C)、胰岛β细胞功能[胰岛素抵抗指数(homeostasis model assessment of insulin resistance，HOMA-IR)与空腹胰岛素(fasting insulin，FINS)]、血糖飘移[日内血糖飘移幅度(intra-day mean amplitude of glycemic excursions，MAGE)、日间血糖飘移幅度(daytime mean of daily difference，MODD)、餐后血糖飘移幅度(mean postprandial glucose excursion，MPPGE)]及体质量指数(body mass index，BMI)，记录2组不良反应的发生情况。结果 治疗后，观察组的FBG、2 hBG、HbA1c、TG、FINS、HOMA-IR、MAGE、MPPGE和MODD明显低于对照组(P<0。05)，HDL-C水平明显高于对照组(P<0。05);2组不良反应的总发生率比较差异无统计学意义(P>0。05)。结论 用罗格列酮联合胰岛素治疗单用胰岛素控制不佳的肥胖T2DM患者，可更好地控制患者的血糖与血脂水平，减轻胰岛素抵抗，降低血糖飘移幅度，且安全性好。
Therapeutic effect of rosiglitazone combined with insulin in obese patients with type 2 diabetes mellitus inadequately controlled with insulin alone
Objective To observe the effect of rosiglitazone combined with insulin on glycemic excursion in obese patients with type 2 diabetes mellitus(T2DM)inadequately controlled with insulin.Methods 106 obese patients with T2DM inadequately controlled with insulin alone were selected as the study subjects.They were divided into 2 groups by using the random number table method.The control group was still treated with insulin,while the observation group was treated with rosiglitazone on the basis of the treatment of control group.Fasting blood glucose(FBG),2 hours postprandial blood glucose(2 hBG),glycosylated hemoglobin(HbA1c),triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),pancreatic β cell function[homeostasis model assessment of insulin resistance(HOMA-IR)and fasting insulin(FINS)],glycemic excursion[intra-day mean amplitude of glycemic excursions(MAGE),daytime mean of daily difference(MODD)and mean postprandial glucose excursion(MPPGE)]and body mass index(BMI)were compared between the 2 groups before and after treatment.Adverse reactions were recorded.Results After treatment,the FBG,2 hBG,HbA1c,TG,FINS,HOMA-IR,MAGE,MPPGE and MODD in the observation group were significantly lower than those in the control group(P<0.05),and the HDL-C level was significantly higher than that in the control group(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the 2 groups(P>0.05).Conclusion Applying rosiglitazone combined with insulin to treat obese patients with T2DM inadequately controlled with insulin alone can better control blood glucose and blood lipid levels,relieve insulin resistance,and reduce glycemic excursion,with good safety.
NETL
NSTL
万方数据
维普
