甘精胰岛素联合不同降糖药稳定2型糖尿病血糖水平的效果

Effect Evaluation of Insulin Glargine with Saxagliptin or Glimepiride in Controlling Blood Glucose Level of Type 2 Diabetes Patients

目的:评价甘精胰岛素联合沙格列汀或格列美脲稳定2型糖尿病血糖水平的作用效果。方法:将我院2收治的228例2型糖尿病患者按照随机数字表法分为研究组和对照组,每组114人。研究组给予沙格列汀联合甘精胰岛素进行治疗,对照组给予格列美脲联合甘精胰岛素进行治疗。全部病例在治疗前4 d及治疗满16周时应用动态血糖监测仪实施72 h动态血糖监测。对比两组治疗前后血糖水平相关指标及血糖水平浮动相关指标的变化。结果:研究组治疗后体质指数显著低于对照组(P<0.05)。两组治疗后空腹血糖均比本组治疗前显著下降(P<0.05)。两组治疗后糖化血红蛋白均比本组治疗前显著下降(P<0.05)。两组治疗后胰岛素用量无显著差异。两组平均血糖水平治疗前后无显著差异(P>0.05)。研究组治疗后血糖标准差、日内血糖平均波动幅度、日内血糖波动次数、日间血糖平均绝对差改善幅度显著优于对照组。两组高血糖治疗后均比治疗前显著改善,改善幅度无显著差异(P>0.05)。两组低血糖曲线下面积治疗前后无显著差异(P>0.05)。结论:甘精胰岛素并用沙格列汀更能在显著控制2型糖尿病患者血糖的同时,还可使其血糖水平保持持久稳定,且不增加其低血糖的发生风险。

Objective： To evaluate the effect of insulin glargine combined with glimepiride or saxagliptin in keeping the blood glu- cose level of type 2 diabetes patients. Methods： 228 cases of type 2 diabetes patients were randomly divided into study group and control group, each group of 114 people. Patients in study group were given saxagliptin plus insulin glargine treatment, and those in the control group were treated with glimepiride plus insulin glargine treatment. Dynamic blood glucose monitor was applied to take 72 h dynamic monitoring of blood glucose for all patients at 4 d before treatment and 16 weeks after treatment. The changes of blood glucose level and floating index related indicators before and after treatment were recorded and analyzed in the two groups. Results： After treatment, the body mass index of the study group was significantly lower than that of the control group （P〈0.05）. The fasting blood glucose and HbAlc levels were significantly decreased after treatment in both groups, as compared with their own before treatment （P〈0.05）. There was no significant difference in insulin dosage between the two groups after treatment. Yet no significant difference was found in the mean blood glucose level before and after treatment in two groups （P〉0.05）. After treatment, the blood glucose standard derivation, the daily blood glucose fluctuation range and frequency, absolute deviation of daytime blood glucose in study group were significantly better than in con- trol group. Patients of high blood glucose all were significantly improved after treatment, and the improvement had no significant differ- ence between two groups （P〉0.05）. There was no significant differences in area under the curve of hypoglycaemia before and after treat- ment in both groups （P〉0.05）. Conclusion： Insulin glargine combined with saxagliptin not only had remarkable effect in control of blood glucose in patients with type 2 diabetes mellitus, but also can keep it in a lasting stable level, while not increase the risk of hypoglycemia.