吡格列酮联合其他降糖药治疗老年糖尿病的疗效分析

Clinical efficacy of the different antidiabetic drugs combined with insulin sensitizers in the treatment of elderly patients with diabetes and analysis of the mechanism

目的探讨吡格列酮胰岛素增敏剂联合不同降糖药治疗老年糖尿病的临床疗效及其作用机制。方法将我院收治的95例2型糖尿病老年患者按照分层随机分组法分为观察组和对照组,对照组给予吡格列酮+格列美脲治疗,观察组给予吡格列酮+瑞格列奈治疗,观察2组治疗前后FINS、PI及血糖控制情况,随访6个月,观察2组患者体质量、BMI、WHR、HOMA-β、HOMA-IRI及血脂水平。结果观察组FINS、PI及血糖水平等临床疗效观察指标显著优于对照组,2组间差异有统计学意义(P<0.05);随访6个月,观察体质量、BMI、HOMA-β及血脂水平等随访观察指标均显著优于对照组,2组间差异有统计学意义(P<0.05)。结论胰岛素增敏剂联合瑞格列奈能增加机体对胰岛素的敏感性和促进胰岛素分泌,从而达到改善胰岛β细胞功能和降低胰岛素抵抗。

Objective To explore the clinical efficacy of the different antidiabetic drugs combined with insulin sensitizers in the treat-ment of elderly patients with diabetes and analysis of the mechanism .Methods According to the stratified randomization method , 95 cases of elderly patients with type 2 diabetes were divided into the observation group and the control group in our hospital .Pa-tients in the control group were given insulin sensitizer ＋ glimepiride and the observation group were given insulin sensitizers ＋nateglinide .FINS ,PI and blood glucose levels of both groups were observed .After the follow-up visit for 6 months ,weight , BMI ,WHR ,HOMA-β,HOMA-IRI and lipid levels of patients in both groups were observed .Results FINS ,PI and blood glu-cose levels of the observation group were significantly better than those of the control group ,with statistical significance （P〈0 .05）;after a follow-up visit for 6 months ,body weight ,BMI ,HOMA-β,HOMA-IRI and lipid levels of the observation group were significantly better than those of the control group ,with statistical significance （P〈0 .05） .Conclusion Insulin sensitizers combined nateglinide can significantly increase the body′s sensitivity to insulin and insulin secretion ,which can improve the islet β-cell function and reduce insulin resistance .