睡前加服吡格列酮/二甲双胍片可改善预混胰岛素治疗的2型糖尿病患者黎明现象
Pioglitazone/metformin before bedtime can improve the dawn phenomenon in patients with type 2 diabetes mellitus treated with premixed insulin

吴秋霞.睡前加服吡格列酮/二甲双胍片可改善预混胰岛素治疗的2型糖尿病患者黎明现象[J].内科急危重症杂志,2021,27(4):

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DOI：10.11768/nkjwzzzz20210406

英文关键词:

基金项目:荆门科技计划项目（No:2019YDKY017)

作者	单位	E-mail
吴秋霞	荆门市第二人民医院(荆楚理工学院附属中心医院）	zhanghua1019@126.com

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中文摘要:

目的：比较吡格列酮/二甲双胍复方片剂与单药二甲双胍片对预混胰岛素治疗的2型糖尿病患者黎明现象的影响。方法：选择2019年1-12月在荆门市第二人民医院住院的使用预混胰岛素治疗后行末梢血糖监测仍存在黎明现象的2型糖尿病患者54例，随机分为2组：吡格列酮/二甲双胍组（A组）28例、二甲双胍组（B组）26例。A组睡前加服吡格列酮/二甲双胍(吡格列酮15mg、二甲双胍500mg)，B组睡前仅加服二甲双胍500mg，动态监测血糖，根据情况适时减少胰岛素用量，治疗1周，比较2组治疗前、后空腹血糖及黎明现象严重程度（Δ黎明）。结果：治疗1周后，2组空腹血糖和Δ黎明较治疗前下降（P均＜0.05）；且A组下降更显著（P均＜0.05）。结论：使用预混胰岛素治疗的2型糖尿病患者，睡前加服吡格列酮/二甲双胍片较二甲双胍单药能更有效改善黎明现象。

英文摘要:

Objective: To compare the effects of pioglitazone/metformin combination and metformin alone on the dawn phenomenon in patients with type 2 diabetes mellitus (T2DM) treated with premixed insulin. Methods: A total of 54 patients who were hospitalized in Jingmen Second People's Hospital from January to December in 2019 with T2DM treated with pre-mixed insulin were confirmed with the dawn phenomenon by self-monitoring of blood glucose and were randomly divided into two groups: pioglitazone/metformin combination group (n=28); metformin group (n=26). In pioglitazone/metformin combination group, pioglitazone/metformin (pioglitazone 15mg, metformin 500mg) was administered before bedtime. In metformin group, metformin (500mg) was given before bedtime. Blood glucose was monitored dynamically, and the amount of insulin was reduced appropriately if the blood glucose was low. After one week of treatment, the two groups were compared by the differences in the fasting glucose and Δdawn before and after treatment. Results: After one week of treatment, the fasting glucose and the Δdawn in both groups decreased as compared with those before treatment (P<0.05). Compared to the metformin group, the fasting blood glucose and the Δdawn were significantly reduced in pioglitazone/metformin combination group (P<0.05). Conclusion: Combined use of pioglitazone/metformin before bedtime was more effective than metformin alone on improving the dawn phenomenon in T2DM treated with premixed insulin.