甘精胰岛素与西格列汀联用治疗口服降糖药控制不佳的老年2型糖尿病的有效性和安全性

Efficacy and Safety of Insulin Glargine Combined with Sitagliptin in Elderly Type 2 Diabetes Patients with Poor Glycemic Control

目的:评价甘精胰岛素联用西格列汀治疗口服降糖药控制不佳的老年2型糖尿病的有效性及安全性。方法:采用随机、开放,门冬胰岛素30平行对照的研究方法,将98例60岁以上口服降糖药物控制不佳的2型糖尿病患者随机分成甘精胰岛素联用西格列汀组(观察组)52例和门冬胰岛素30特充组(对照组)46例,根据血糖情况调整用药剂量,治疗12周后比较两组的空腹血糖(FBG)、餐后2h血糖(2hPBG)、糖化血红蛋白(HbA1c)、低血糖发生率及体质指数(BMI)。结果:观察组FBG和低血糖发生率均低于对照组(P<0.05);2hPBG、HbA1c和BMI等指标比较两组差异无统计学意义(P>0.05)。结论:甘精胰岛素与西格列汀联用对口服降糖药控制不佳老年2型糖尿病患者是一种安全、有效且方便的治疗方案,低血糖发生率低,通过糖尿病教育的实施,将是一种很好的治疗方案。

Objective： To investigate the efficacy and safety of insulin glarsine combined with sitagliptin in elderly type 2 diabetic patients whose blood glucose levels were inadequately controlled by oral anti-diabetic drugs（ OAD）. Methods： In the open-labeled,randomized and parallel study,98patients（ ≥60 years） were randomly divided into two groups： insulin glargine / sitagliptin combination group（ n = 52,the observation group） and insulin Aspart 30 injection group（ n = 46,the control group）. The dose was adjusted according to the blood glucose. The fasting blood glucose（ FBG）,2h postprandial blood glucose（ 2hPBG）,glycosylated hemoglobin（ HbA1c）,the incidence of hypoglycemia and body mass index（ BMI） after the 12-week treatment were compared between the two groups. Results： The fasting glucose and the incidence of hypoglycemia in the observation group were lower than those in the control group（ P〈0.05）. There were no significant differences in 2h postprandial blood glucose,Hb A1 c and BMI between the two groups（ P〉0.05）. Conclusion： The treatment of insulin glargine combined with sitagliptin is safe,effective and convenient in elderly type 2 diabetes patients with poor glycemic control. By diabetic education,the lower incidence of hypoglycemia treatment will be a better choice for elderly type 2 diabetic patients.