DPP-Ⅳ抑制剂联合胰岛素强化降糖治疗对胰岛修复的影响

Effect of DPP-Ⅳ inhibitor combined with insulin intensive therapy on pancreatic islet repair

目的:考察DPP-Ⅳ抑制剂联合胰岛素强化降糖治疗对胰岛修复的影响。方法:选取90例初诊2型糖尿病患者随机分为观察组和对照组,每组45例。观察组患者给予预混型胰岛素早、晚餐前皮下注射治疗,设定靶血糖值(fasting blood glucose,FBG)<6.1 mmol/L,2h PG<7.8 mmol/L,沙格列汀起始剂量5 mg/次,1次/d。对照组给予胰岛素早预混型胰岛素早、晚餐前皮下注射治疗,设定靶血糖值FBG<6.1 mmol/L,2h PG<7.8 mmol/L,安慰剂1次/d。比较两组患者血糖水平、血脂水平、糖化血红蛋白(hemoglobin A1c,Hb A1C)、胰岛β细胞功能(HOMA-β)和胰岛素抵抗指数(HOMAIR)差异。结果:治疗前两组患者各指标差异无统计学意义(P>0.05),治疗12周后,观察组患者血糖水平显著低于对照组患者(t=1.756,t=2.369,P<0.05),血脂水平与对照组患者比较差异无统计学意义(P>0.05)。观察组患者治疗后HOMA-β显著高于对照组,且Hb A1C、HOMA-IR水平显著低于对照组(t=2.219,t=1.896,t=1.934,P<0.05)。结论:DPP-Ⅳ抑制剂联合胰岛素强化降糖治疗可以更好地修复胰岛功能。

Objective： To investigate the effect of DPP-IV inhibitor combined with insulin intensive therapy on pancreatic islet repair. Methods： 90 patients with newly diagnosed type 2 diabetic patients were randomly divided into observation group and control group, 45 cases in each group. The observation group were treated with subcutaneous injection ofpre-mixed insulin before breakfast and dinner, setting target blood glucose value FBG 〈6.1 mmol/L, 2hPG 〈7.8 mmol/L, onglyza 5 mg/d. The control group received subcutaneous injection of insulin before breakfast and dinner therap）5 set the target blood glucose value 2hPG Blood glucose level, blood lipid levels, glycosylated hemoglobin insulin resistance index （HOMA-IR） were compared between the 〈7.8 mmol/L, FBG 〈6.1 mmol/L, and placebo. （HbAlc）, islet cell function （HOMA-[~） and two groups. Results： There was no significant difference for all indexes between the two groups before treatment （P〉0.05）. After 12 weeks, the blood glucose level in the observation group was significantly lower than that in the control group （t=1.756, t=2.369, P〈0.05）, the difference of blood liquid was not statistically significant （P〉0.05）. After treatment, the HOMA-[~ was significantly higher in the observation group than that in the control group, and the level of HbAIC and HOMA- IRwas significantly lower than that in the control group （t=2.219, t=1.896, t=1.934, P〈0.05）. Conclusion： DPP- IV inhibitor combined with insulin intensive therapy can improve the function of pancreatic islet in patients with type 2 diabetes.