短期胰岛素强化与西格列汀联合二甲双胍治疗初诊断的2型糖尿病的对比研究

Study on the comparison between short-term intensive insulin therapy and combined application of sitagliptin and metformin for the patients primarily diagnosed of type 2 diabetes

目的对比短期胰岛素强化与西格列汀联合二甲双胍治疗初诊断的2型糖尿病患者的临床疗效。方法选取我院收治的120例初诊断的2型糖尿病患者,随机分为A、B两组,每组60例。A组采用短期胰岛素强化治疗,B组采用口服二甲双胍+西格列汀进行治疗。结果治疗后两组FPG、2hPG、HbA1c均较治疗前显著降低(均P<0.05),治疗后两组FPG、2hPG、HbA1c比较差异无统计学意义(均P>0.05)。治疗后两HOMA-β、HOMA-IR均较治疗前显著改善(均P<0.05);但两组HOMA-β、HOMA-IR比较差异无统计学意义(均P>0.05)。治疗后B组GC较治疗前显著降低(P<0.05),A组GC与治疗前比较无显著变化(P>0.05)。治疗后两组ADP均较治疗前显著上升,Leptin、FFA均较治疗前显著下降(均P<0.05),但B组ADP上升更为明显,Leptin、FFA下降更为明显(均P<0.05)。两组血糖达标时间比较差异无统计学意义(P>0.05),A组低血糖发生率显著高于B组(P<0.05)。结论短期胰岛素强化与西格列汀联合二甲双胍均可控制患者血糖水平,改善胰岛β细胞功能,但西格列汀联合二甲双胍可抑制GC水平,有效升高ADP并降低瘦素及FFA浓度,且低血糖发生率低。

Objective To compare the clinical efficacy between the short-term intensive insulin therapy and setagliptin combined with metformin in the treatment of newly diagnosed type 2 diabetes mellitus. Methods 120 patients newly diagnosed of type 2 diabetes mellitus who were admitted to our hospital were selected and randomly divided into group A and group B, each group （30 cases. Group A was given short-term intensive insulin therapy, and group B was orally given metformin＋sitagliptin. Results After treatment, FPG, 2 hPG and HbAlc in both groups were significantly lower than those before treatment（P〈0.05）. There was no statistically significant difference in FPG, 2 hPG and HbAlc between the two groups after treatment（P〉0.05）. After treatment, HOMA-β and HOMA-IR in both groups were significantly improved （P〈0.05）; however, there was no statistically significant difference in HOMA-β and HOMA-IR between the two groups（P〉0.05 for both）. After treatment, GC in group B was significantly lower than that before treatment （P〈0.05）, and there was no significant change of GC in group A compared with that before treatment（P〉0.05）. After treatment, ADP was significantly higher than that before treatment in both groups, and Leptin and FFA were significantly lower than those before treatment （P〈0.05）. However, in group B, ADP was increased more significantly, and leptin and FFA were decreased more significantly（P〈0.05）. There was no statistically significant difference in the standardization time of blood glucose between the two groups（P〉0.05）, and the incidence of hypoglycemia in group A Was significantly higher than that in group B（P〈0.05）. Conclusion Short-term intensive insulin therapy and sitagliptin combined with metformin are both able to control the blood glucose levels and improve the function of pancreatic β-cell. However, sitagliptin combined with metformin can inhibit GC levels, effectively increase ADP and reduce Leptin and FFA concentrations, and the incidence of hypoglycemia is low.