沙格列汀对血糖未达标的2型糖尿病患者的疗效

Efficacy of saxagliptin in failed glycemic control of patients with type 2 diabetes mellitus

目的观察血糖未达标的2型糖尿病患者在原有药物的基础上加用沙格列汀的疗效。方法选取2013年6月~2014年12月在宁波市第一医院内分泌科就诊的172例血糖控制不达标的患者经过8周的生活方式宣教后,在原有药物的基础上加用沙格列汀片,治疗12周。观察糖化血红蛋白（Hb A1c）,空腹血糖（fasting blood glucose,FBG）,餐后2 h血糖（2-hours postprandial blood glucose,2h PBG）、体重指数（body mass index,BMI）、胰岛素用量及不良反应事件。结果加用沙格列汀片治疗12周后FBG、Hb A1c、2h PBG较加药前均明显下降[（7.1±2.0）vs.（8.3±1.6）mmol/L,（10.2±2.3）vs.（15.2±2.9）mmol/L,（7.0±1.5）vs.（8.0±1.7）%],差异具有统计学意义（均P〈0.05）,而BMI比较差异无统计学意义[（24.4±3.0）vs.（24.9±2.7）kg/m2]。治疗前使用胰岛素的患者加用沙格列汀12周治疗后胰岛素的日使用剂量明显减少[（22.6±7.9）vs.（32.3±8.2）U/d],且差异具有统计学意义（P〈0.05）。治疗过程中,2例患者因消化道症状不能耐受而退出试验。结论血糖未控制的2型糖尿病患者在原有降糖药物的基础上加用沙格列汀可以有效控制FBG、2h PBG、Hb A1c,可减少胰岛素用量,不增加体质量。

Objective To explore the efficacy of saxagliptin in the treatment of failed glycemic control of patients with type 2 diabetes mellitus on the basis of established treatments. Methods 172 cases of failed glycemic control of patients with type 2 diabetes mellitus from June 2013 to December2014 in department of endocrinology of the first hospital of Ningbo were selected and received health education of 8 weeks,then received saxagliptin on the basis of established treatments for a consecutive treatment of 12 weeks. The Hb A1 c,fasting blood glucose（ FBG）,2-hours postprandial blood glucose（ 2h PBG）,body mass index（ BMI）,insulin dosage and adverse event were observed. Results The FBG,Hb A1 c and 2h PBG after treatment of12 weeks were significantly lower than those pre-treatment[（ 7. 1 ± 2. 0） vs.（ 8. 3 ± 1. 6） mmol / L,（ 10. 2 ± 2. 3） vs.（ 15. 2 ± 2. 9） mmol / L,（ 7. 0 ± 1. 5）vs.（ 8. 0 ± 1. 7） % ],with significant difference（ all P〈0. 05）,while there was no significant difference in BMI between pre-and post- treatment[（ 24. 4 ± 3. 0） vs.（ 24. 9 ± 2. 7） kg/m2]. The insulin dose after treatment of 12 weeks was significantly lower than that pre-treatment[（ 22. 6 ± 7. 9） vs.（ 32. 3 ± 8. 2） U/d],with significant difference（ P〈0. 05）. There were two patients dropout because of the intolerable digestive tract symptom.Conclusion The adding of saxagliptin could control FBG,2h PBG and Hb A1 c effectively and decrease insulin dose,without gaining weight in the treatment of failed glycemic control of patients with type 2 diabetes mellitus on the basis of established treatments.