2型糖尿病患者口服降糖药失效后改用胰岛素治疗对血管并发症的影响被引量：2

Effect of insulin therapy shifted from OHA on the vascular complications in T2DM patients with secondary failure of oral hypoglycemic agents

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摘要目的探讨T2DM患者口服降糖药(OADs)治疗失效后改用胰岛素治疗对血管并发症发生率的影响和相关危险因素。方法选取我院住院及门诊患者453例,分为治疗组(232例)和对照组(221例)。治疗组注射胰岛素,严格控制FPG在6mmol/L左右;控制饮食,每日摄入热卡25kcal/kg;每日快走或慢跑5km以上等。对照组口服磺脲类+双胍类+罗格列酮或吡格列酮,控制饮食、加强运动。跟踪随访8年,观察并记录血管并发症发生情况。结果治疗组冠心病、DR和周围神经病变发生率低于对照组(P<0.05)。两组DN、脑梗死发生率差异无统计学意义(P>0.05)。结论 T2DM患者OADs失效后应尽快采用注射胰岛素、加强运动、控制饮食、减轻体重等干预治疗,可明显减少血管并发症发生。 Objective To observe effect of insulin therapy shifted from OHA on the vascular complications in T2DM patients with secondary failure of oral hypoglycemic agents. Methods The 453 T2DM patients with failure of oral hypoglyeemic agents were divided into two groups, 232 in the treatment group and 221 in the control group. The treatment group was treated with insulin injection to strictly control the fasting plasma glucose in the range of 6 retool/L, on the diet of intake of 25 kcal/kg everyday, and walking for more than 5 km daily. The control group was treated with oral sulfaurea drugs ＋ biguanide ＋ rosigoitazone or pioglitation, diet, and exercises. Both groups were followed up for 8 years for observing the possible vascular complications. Results The treatment group had a lower incidence of coronary heart disease, and retinopathy and peripheral neuropathy（P〈0. 05）. There was no difference between the two groups in the incidence of cerebral infarction and nephropathy（P〉0. 05）. Conclusion The T2DM patients with failure of oral hypoglycemic agents should be treated by insulin injection, exercises, diet control, and reducing body weight as soon as possible, in ease of which, the incidence of vascular complications is significantly to be less.

作者陈树铭陈景言

机构地区成都市双流县第一人民医院四川省人民医院

出处《中国糖尿病杂志》 CAS CSCD 北大核心 2012年第6期441-443,共3页 Chinese Journal of Diabetes

关键词糖尿病 2型口服降糖药失效干预治疗 Diabetes mellitus, type 2 Failure of the oral hypoglycemie agents Intervention

分类号 R587.1 [医药卫生—内分泌]

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