利格列汀对肾功能不全的老年2型糖尿病患者血糖变化的影响

Effect of linagliptin on blood glucose fluctuation in elderly type 2 diabetic patients with renal failure

目的探讨利格列汀对肾功能不全的老年2型糖尿病患者血糖控制的疗效及安全性。方法选取肾功能不全的老年2型糖尿病患者56例,服用利格列汀前,采用实时动态血糖监测系统(real-time glucose monitoring system,RGM S)持续监测血糖3 d,口服该药物后,RGM S持续监测3 d。比较给药前24 h与给药后第3天的24 h平均血糖水平、血糖标准差、最大血糖漂移幅度、平均血糖漂移幅度、高血糖比例、低血糖比例,并比较用药前和用药后3个月糖化血红蛋白和肾小球滤过率。结果给予利格列汀后24 h平均血糖水平、血糖标准差、最大血糖漂移幅度、平均血糖漂移幅度、高血糖比例、糖化血红蛋白均明显降低,没有低血糖发生,并且肾小球率过滤无明显变化。结论利格列汀能安全、方便、有效地显著减少肾功能失代偿的老年2型糖尿病患者的血糖漂移幅度,降低高血糖、减少低血糖发生。

Objective To assess the efficacy and safety of linagliptin in treatment of elderly type 2 diabetic patients with renal failure. Methods Fifty six elderly type 2 diabetic patients with renal failure admitted in our hospital were enrolled in the study. Real-time glucose monitoring system （RGM） was performed for 3 days before and after linagliptin treatment respectively. The mean 24 h blood glucose level（ MBG）, SD of the 24 h blood glucose level（ SDBG）, large and mean amplitude of glycemic excursions（LAGE and MAGE）, hyperglycemic and hypoglycemic time periods, HbA1c and glomerular filtration rate （GFR） were compared before and after treatment. Results Linagliptin decreased the MBG, SDBG, LAGE, MAGE, hyperglycemic and hypoglycemic time periods and HbA^c, and there was no significant difference in GFR changes before and after treatment. Conclusion linagliptin improves the average glycemic level and glycemic fluctuation, and it is safe and convenient for elderly type 2 diabetic patients with renal failure.