摘要
Abstract
Objective To explore the effect of glimepiride combined with metformin on insulin resistance and islet beta cell function in patients with newly diagnosed type 2 diabetes( T2DM)companied with NAFLD. Methods We enrolled 58 patients who were newly diagnosed with T2DM combined with NAFLD in Ganzhou People' s Hospital from January 2012 to December 2013. Using random number table method,the patients were randomly divided into control group( n = 28)and treatment group(n = 30). The two groups were both administrated with metformin by 1 500 mg/ d;the control group was also orally administrated with glipizide controlled release tablets by 5 mg/ d,and the treatment group was also orally given glimepiride 2 mg/ d;the drug dosage was adjusted according to blood glucose. Before intervention and after 12 weeks intervention,75 g OGTT was administrated after drug with drawal for 3 days,and blood glucose and insulin level were measured at 0,30,60,120 and 180 min after OGTT. Results Before treatment,the two groups were not significantly different in FBG,2 h PG,HbA1c , FINS,HOMA-IR,lnHRI,lnMSI,HOMA-βF,early - phase insulin secretion index and late - phase insulin secretion index (P ﹥ 0. 05). After 12 weeks of intervention,the two groups were not significantly different in FBG,2 h PG,HbA1c ( P ﹥0. 05);the treatment group was higher in FINS,lnMSI,lnHOMA-βF,early - phase insulin secretion index,and lower in HOMA-IR,lnHRI,late - phase insulin secretion index( P ﹤ 0. 05). After treatment,the indexes of the two groups were significantly different from those before treatment( P ﹤ 0. 05). During treatment,hypoglycemia occurred in 3 patients in the treatment group and 9 patients in the control group,with significant difference in the incidence of hypoglycemia between the two groups(χ2 = 4. 33,P = 0. 037). Conclusion Glimepiride or glipizide controlled - release tablets combined with metformin both can effectively improve insulin resistance and early phase insulin secretion in patients with newly diagnosed T2DM combined with NAFLD. Glimepiride combined with metformin is more effective in improving insulin resistance and early phase insulin secretion,and is more helpful for blood glucose control.关键词
糖尿病,2型/脂肪肝/格列美脲/胰岛素抗药性/β细胞,胰腺Key words
Diabetes mellitus,type 2/Fatty liver/Glimepiride/Insulin resistance/Beta cells,pancreas分类
医药卫生
