Treatment of type 2 diabetes patients with renal insufficiency by adding glimepiride to insulin
Wang Suli
Li Jinghua
Liu Linan
Mu Yong
Shen Jichun
Wang Ying
Abstract：Objective To observe the effects of adding glimepiride on type 2 diabetic patients with renal insufficiency who was poorly controlled by insulin.Methods Seventy eight cases of type 2 diabetes patients with renal insufficiency,poorly controlled with large dose insulin,were randomly divided into glimepiride-added group (GM,n =38) and insulin group (INS,n =40).The INS group adjusted insulin dose until the plasma glucose was satisfying.The GM group added glimepiride.HbA1c,plasma glucose,daily insulin dose,number of hypoglycemic events,body weight,plasma lipid concentration,the levels of high sensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α) and HOMA-IR were measured before and 12 weeks after the therapy.Results At 12 weeks,body weight and daily insulin dose in INS group were significantly higher than those before treatment [(78 ± 12) kg vs (74 ± 12) kg,(88 ± 11) U vs (66 ± 11) U] ; fasting blood glucose,2 h postprandial blood glucose,HbAlc and triglycerides were decreased [(8.2 ± 2.2) mmol/L vs (10.5 ± 1.9) mmol/L,(14.2 ± 2.3) mmol/L vs (16.8 ±2.3)mmol/L,(7.6 ±0.8)％ vs (8.9 1.2)％,(2.6 ± 1.1)mmol/L vs (3.7 ± 1.2)mmol/L] (P ＜ 0.05 or P ＜ 0.01).In GM group,body weight,glutamic-pyruvic transaminase,fasting blood glucose,2 h postprandial blood glucose,HbAlc,triglycerides hs-CRP,HOMA-IR,TNF-α and daily insulin dose were lower than those before treatment [(72 ± 11) kg vs (74 ± 11) kg,(43 ± 4) U/L vs (57 ± 6) U/L,(7.4 ± 1.5) mmol/L vs (10.8 ±2.0)mmol/L,(10.9 ± 1.9) mmol/L vs (16.5 ±2.4) mmol/L,(6.8 ±0.6)％ vs (8.5 ±0.9)％,(2.3 ± 1.0)mmol/L vs (3.7 ± 1.2)mmol/L,(2.2 ± 1.0)mg/L vs (4.5 ± 1.0)mg/L,(2.1 ±0.6) vs (3.3 ±0.8),(16 ± 4) μμg/L vs (24 ± 6) μg/L,(40 ± 12) U/d vs (68 ± 11) U/d,respectively].There were 3 cases of severe hypoglycemic events in the INS groups.There was no statistically significant difference in mild hypoglycemic events and BUN,Cr in two groups (P ＞ 0.05).Conclusion Adding glimepiride to insulin therapy in the type 2 diabetes patients with renal insufficiency is safe and effective.
Keywords：Type 2 diabetes mellitusRenal insufficiencyInsulinGlimepiride
Publication Date：2015-02-28
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 204-208 )