德谷胰岛素联合利格列汀对高龄2型糖尿病患者疗效、血糖波动及低血糖事件的影响

Effects of degludec combined with Lieglitine on the efficacy, Blood Glucose fluctuation and hypoglycemia in elderly patients with type 2 diabetes mellitus

目的采用自身前后对照方式探讨德谷胰岛素联合利格列汀对高龄2型糖尿病患者的血糖指标、血糖波动指标、低血糖事件、患者满意度、漏药次数及患者体重的影响等。方法选择2019年1月至2020年3月在本院诊治的高龄2型糖尿病患者96例,平均年龄80.4±8.9岁,男性52例,女性44例,就诊时均使用2-4种口服降糖药物规范治疗3月以上,且存在血糖不达标、血糖波动大或反复发生低血糖事件等问题之一。在知情同意的前提下,给予调整为德谷胰岛素联合口服利格列汀片治疗,随访观察16周,分析治疗前后患者血糖指标、血糖波动指标、低血糖事件变化、患者满意度、患者漏药次数及体重影响。结果入选患者空腹血糖由调整前9.6±3.1 mmol/L下降为6.2±1.8 mmol/L(P<0.05),平均餐后血糖由15.4±3.8 mmol/L下降为9.5±2.9 mmol/L(P<0.05),餐后血糖波动幅度由4.2±0.4 mmol/L下降为2.4±0.2 mmol/L(P<0.05),平均糖化血红蛋白由10.1±3.3%下降为7.4±1.2%(P<0.05),糖化血红蛋白达标率由27.5±3.2%上升为83.6±6.6%(P<0.05)。调整后无明确的低血糖事件发生,患者对治疗的综合满意度由23.2±4.2%上升为93.5±5.5%(P<0.05),调整后患者漏药次数由治疗前人均2.5±0.4次/周下降为人均0.5±0.1次/周(P<0.05),平均体重由65.3±8.4 kg增加为66.5±9.2 kg(P>0.05)。结论对于口服药物治疗不达标的高龄2型糖尿病患者,德谷胰岛素联合利格列汀能够有效降低血糖、减少血糖波动及低血糖事件,提高患者满意度,降低漏药次数,体重影响小。

Objective To investigate the effect of degludec combined with Lieglitine on Blood glucose fluctuation and hypoglycemia in elderly patients with type 2 diabetes mellitus.Methods 96 elderly patients with average age of 80.4±8.9 years including 52 males and44 females who admitted to our hospital from January 2019 to March 2020 were selected.They were treated with 2 or 4 kinds of oral hypoglycemics,there were some problems such as poor control of blood glucose,high fluctuation of blood glucose or frequent hypoglycemia among those patients.After signing informed consent,All patients were treated with degludec combined with oral Linagliptin,and were followed up for 16 weeks.The changes of blood glucose level,blood glucose fluctuation and hypoglycemia events were analyzed.Results The fasting blood glucose decreased from 9.6±3.1 mmol/L to 6.2±1.8 mmol/L(P<0.05),and the mean postprandial blood glucose decreased from 15.4±3.8 mmol/L to 9.5±2.9 mmol/L(P<0.05).The range of postprandial blood glucose fluctuation decreased from 4.2±0.4 mmol/L to 2.4±0.2 mmol/L(P<0.05).The mean glycated hemoglobin decreased from 10.1±3.3%to 7.4±1.2%(P<0.05),and the success rate increased from 27.5±3.2%to 83.6±6.6%(P<0.05).After adjustment,there was no definite hypoglycemia,and satisfaction degree of the patients about treatment increased from 23.2±4.2%to 93.5±5.5%(P<0.05).Conclusion Degludec combined with Lieglitine can decrease blood glucose,decrease blood glucose fluctuation and hypoglycemia events in elderly patients with type 2 diabetesm ellitus,and they also can improve the satisfaction degree of patients,avoid the drug missing,and have little effect on bodyweight.