西格列汀联合胰岛素泵强化治疗初发2型糖尿病的疗效探讨

Efficacies of sitagliptin as add-on therapy with insulin-pump for newly diagnosed type 2 diabetes mellitus patients

目的:观察西格列汀联合胰岛素泵强化降糖治疗初发2型糖尿病(T2DM)患者的效果。方法:回顾性分析60例新诊断T2DM患者临床资料,其中单纯胰岛素泵降糖治疗组30例(A组),西格列汀联合胰岛素泵降糖组30例(B组),两组治疗时间均为2周。比较两组患者治疗前后的空腹血糖(FBG)、餐后2 h血糖(2 h PG)、空腹C肽、餐后2 h C肽、糖化血红蛋白(Hb A1C)、体质量指数(BMI)以及血糖达标时间及最终胰岛素用量、低糖血症发生率。结果:治疗两周后,两组的FPG、2 h PG均较治疗前降低(P<0.05),空腹C肽及餐后2 h C肽均较治疗前升高(P<0.05);治疗后B组2 h PG较A组降低(P<0.05),2 h C肽较A组升高(P<0.05),Hb A1c及BMI比较差异无统计学意义(P>0.05)。治疗后B组血糖达标时间短于A组,最终胰岛素用量少于A组,低血糖发生率低于A组,差异均有统计学意义(P<0.05)。结论:西格列汀联合胰岛素泵治疗初发2型糖尿病患者,能够更好地控制餐后血糖、提升胰岛功能,同时可缩短治疗时间,降低胰岛素使用量,减少低血糖的发生。

Objective： To observe the efficacies of sitagliptin as add-on therapy with insulin-pump for the newly diagnosed type 2 diabetes mellitus（ T2DM） patients.Methods： Sixty patients of newly diagnosis T2 DM were included and the therapeutic outcomes were reviewed through grouping.Group A（ n = 30） received simple insulin-pump treatment,and group B（ n = 30） were given add-on therapy with the insulin-pump for two weeks. Then the two groups were compared regarding the fasting blood glucose（ FBG）,2-hour postprandial glucose（ 2 h PG）,C-peptide（ C-P）,glycated hemoglobin（ Hb A1C）,body mass index（ BMI）,the time of normal blood glucose restoration,final dose of insulin consumed and incidence of hypoglycemia before and after administration.Results： After two weeks of treatment,FBG and 2 h PG were decreased and C-peptide was increased for the two groups of patients（ P〈0. 05）.Group B had lower 2 h PG,yet elevated 2-hour C-peptide level than group A（ P〈0.05）.The difference of Hb A1 C and BMI was not significant between two groups（ P〉0.05）.However,group B had shorter time to restore the normal blood glucose,lower insulin dose and incidence of hypoglycemia than group A.The difference was significant（ P〈0.05）.Conclusion： Sitagliptin as add-on therapy with insulin-pump may lead to better control of the 2 h PG level,improvement of islet β-cell function,reduced therapy course and insulin dose as well as incidence of hypoglycemia for newly diagnosed T2 DM patients.