Clinical Effect Of Combined Treatment Of Insulin Glargine,glimepiride And Acarbose In Patients With Type 2 Diabetes Mellitus With Secondary Failure Of Sulfonylureas

Objective To observe clinical effect of combined treatment of insulin glargine,glimepiride and acarbose in patients with type 2 diabetes mellitus with secondary failure of sulfonylureas,and to analyse the blood glucose level and the relevant indexes before and after treatment,as well as to provide the basis of selecting the theraputic regimen in type 2 diabetes mellitus with secondary failure of sulphonylureas.Methods A total of 48 patients with type 2 diabetes mellitus with secondary failure of sulfonylureas,who visited our department during Septermber 2013 to December 2014,were included in this study.All patients received combined treatment of subcutaneous injection of insulin glargine(10U each time,OD),glimepiride(1mg each time,OD)and acarbose(50mg each time,TID)for 3months.Blood lipid,blood glucose and pancreas islet function were determined before treatment and after treatment for 3 months.The adverse reactions were recorded during treatment.Results(1)The levels of fasting glocuse,2 hour postprandial glucose and hemoglobin A1 c after 3 months treatement decreased compared with those before treatment with significant statistic difference in patients with type 2 diabetes mellitus with secondary failure of sulfonylureas(P<0.01).(2)The levels of blood glocuse at each time point in the dynamic blood glucose determination after 3 months treatement decreased compared with those before treatment with significant statistic difference in patients with type 2diabetes mellitus with secondary failure of sulfonylureas(P<0.01).(3)The mean level of blood glocuse in the dynamic blood glucose determination after 3 months treatement decreased compared with those before treatment,and the duration of blood glocuse up to standard increased with significant statistic difference after 3 months treatement in patients with type 2 diabetes mellitus with secondary failure of sulfonylureas(P<0.01).(4)The levels of fasting insulin in patients with type 2 diabetes mellitus with secondary failure of sulphonylurea increased significantly(P<0.01),homeostasis model insulin resistance index decreased significantly(P<0.01),and homeostasis model assessment-B were not significently different compared with those before treatment(P>0.05).(5)The levels of triglyceride,total cholesterol,low density lipoprotein-cholesterol have the tendency to decrease after 3 months treatement,and the level of high density lipoprotein-cholesterol has the tendency to increase after 3 months treatement in patients with type 2diabetes mellitus with secondary failure of sulfonylureas,but there was no significent difference compared with those before treatment(P>0.05).(6)A total of 13 hypoglycemia events occurred during 3 months-treatment in48 patients with type 2 diabetes mellitus with secondary failure of sulfonylureas,but no severe hypoglycemia events companied by disturbance of consciousness occurred.Conclusion Combined treatment of insulin glargine,glimepiride and acarbose can effectively and stably control blood glucose in patients with type 2 diabetes mellitus with secondary failure of sulfonylureas,and has the favourable safety.