Iavicoli M, Cucinotta D, De Mattia G, Lunetta M, Morsiani M, Pontiroli A E, Pozza G
Novo Italy, Roma.
Diabet Med. 1988 Dec;5(9):849-55. doi: 10.1111/j.1464-5491.1988.tb01123.x.
The influence of combined therapy using insulin and oral hypoglycaemic agents on blood glucose control and on insulin secretion in Type 2 diabetic patients with secondary failure to oral hypoglycaemic agents was evaluated. Type 2 diabetic patients (n = 180) (98 normal-weight, 82 over-weight), at least 3 years from diagnosis, and having poor blood glucose control on oral hypoglycaemic agents for at least 3 months (fasting plasma glucose greater than 10.0 mmol l-1) despite intensive efforts at improvement, were included in the study. A single daily insulin injection (human ultralente), at a dose of 0.22 +/- 0.07 U kg-1 d-1 in normal-weight and 0.33 +/- 0.10 U kg-1 d-1 in over-weight patients, was added to the previous dietary and drug treatment for 6 months. A progressive and significant (2p less than 0.001) reduction of the mean daily blood glucose was observed during the first 3 months of combined therapy (from 13.2 +/- 3.2 to 8.1 +/- 2.1 mmol l-1 in normal-weight and from 13.4 +/- 3.1 to 8.8 +/- 2.3 mmol l-1 in over-weight patients), with no further significant changes thereafter. A significant increase (2p less than 0.001) in the mean daily C-peptide concentration (from 0.50 +/- 0.30 to 0.71 +/- 0.29 nmol l-1 in normal-weight and from 0.78 +/- 0.36 to 1.00 +/- 0.41 nmol l-1 in over-weight patients) took place during combined therapy. No changes of body weight (+ 1.5 +/- 1.2 kg in normal-weight and + 1.0 +/- 1.0 kg in over-weight patients) were observed.
评估了胰岛素与口服降糖药联合治疗对口服降糖药继发性失效的2型糖尿病患者血糖控制及胰岛素分泌的影响。纳入研究的2型糖尿病患者共180例（98例体重正常，82例超重），自确诊至少3年，尽管经积极改善血糖控制仍不佳，口服降糖药至少3个月（空腹血糖大于10.0 mmol/L）。在原有饮食和药物治疗基础上，每日单次注射人长效胰岛素，体重正常患者剂量为0.22±0.07 U·kg⁻¹·d⁻¹，超重患者为0.33±0.10 U·kg⁻¹·d⁻¹，持续6个月。联合治疗的前3个月，平均每日血糖显著逐步降低（体重正常患者从13.2±3.2降至8.1±2.1 mmol/L，超重患者从13.4±3.1降至8.8±2.3 mmol/L，P＜0.001），此后无进一步显著变化。联合治疗期间，平均每日C肽浓度显著升高（体重正常患者从0.50±0.30升至0.71±0.29 nmol/L，超重患者从0.78±0.36升至1.00±0.41 nmol/L，P＜0.001）。未观察到体重变化（体重正常患者增加1.5±1.2 kg，超重患者增加1.0±1.0 kg）。
