基础胰岛素联合DPP-4抑制剂治疗2型糖尿病患者的临床观察

Clinical observation on the therapeutic effect of basic insulin combined with DPP-4 inhibitors in treatment of patients with type 2 diabetes

目的:探讨基础胰岛素联合二肽基肽酶Ⅳ(DPP-4)抑制剂在治疗2型糖尿病方面的临床疗效。方法:将80例2型糖尿病(FBS>11.1 mmol/L)患者随机分成治疗组与对照组,各40例,全部患者均给予生活方式干预,治疗组给予地特胰岛素联合西格列汀100 mg,1次/d,餐前口服;对照组给予地特胰岛素联合瑞格那奈1 mg,3次/d,3餐前口服治疗。结果:经治疗16周后,治疗组患者在空腹及餐后2 h血糖(PBG、2h PBG),糖化血红蛋白(Hb A1C),血脂谱,体重指数(BMI)较前明显下降(P<0.05);与对照组比较,结果具有显著性差异(P<0.05);2组患者比较,胰岛β功能均较治疗前明显下降,但治疗组改善情况更为明显(P<0.05);治疗期间2组患者均未出现低血糖反应,未见其它临床不良反应,2组比较无显著性差异(P>0.05)。治疗组患者血糖达标率显著高于对照组,血糖达标中位时间显著短于对照组(P<0.05)。结论:基础胰岛素联合DPP-4抑制剂在治疗2型糖尿病方面具有较好的临床疗效,且治疗安全性高。

Objective： To explore the clinical therapeutic effect of basic insulin combined with DPP 4 inhibitors in treatment of type 2 diabetes mellitus. Methods： Eighty cases with type 2 diabetes（ FBG 11. 1 mmol / L） were randomly divided into the treatment group and control group,40 cases for each group. All patients were given lifestyle intervention,treatment group received insulin combined with Sitagliptin 100 mg orally before meal once a day,the control group received insulin combined with Regal Nana 1 mg orally before meals three times a day. Results： After treatment for 16 weeks,FBG and two hours postprandial blood glucose（ FBG,2 HPBG）,Hb A1 C,blood lipids,body mass index（ BMI） significantly lowered in treatment group（ P 0. 05）,compared with those of control group,the results showed significant differences（ P 0. 05）.Beta cells function was significantly decreased in two groups than those before treatments,but it improved more significantly in treatment group（ P 0. 05）. Hypoglycemia and other clinical adverse reactions were not seen in two groups,and there was no significant difference between two groups（ P 0. 05）. The blood sugar control rate was higher in treatment group than that in control group,and the median time for achievement of blood glucose control was significantly shorter in treatment group（ P 0. 05）. Conclusions： Basic insulin combined with DPP 4 inhibitors in treatment of type 2 diabetes is safe and has good clinical therapeutic effect.