单用二甲双胍血糖控制不达标的老年2型糖尿病患者联合西格列汀治疗的临床疗效及安全性分析

Clinical efficacy and safety of sitagliptin in patients with type 2 diabetes mellitus treated with metformin alone

目的探讨单用二甲双胍血糖控制不达标老年2型糖尿病(type 2 diadetes mellitus,T2DM)患者联合西格列汀治疗的临床疗效及安全性。方法选取2013年5月—2016年5月延安大学附属医院门诊收治的128例单用二甲双胍治疗血糖不达标的老年T2DM患者作为研究对象,按治疗方法将其分为对照组和观察组,每组64例,对照组在T2DM基础治疗上予以二甲双胍和吡格列酮治疗,观察组在对照组治疗基础上联合西格列汀,2组患者均治疗3个月,治疗结束后比较2组患者间血糖控制水平,并记录比较2组患者在治疗过程中不良反应的发生情况。结果 2组患者治疗前其空腹血糖(fasting plasma glucose,FPG)、餐后2 h血糖(2 hours posprndial blood glucose,2h PG)、糖化血红蛋白(hemoglobin Alc,Hb A1c)水平和体质量指数(BMI)比较均差异无统计学意义(P>0.05),治疗后观察组FPG、2h PG和Hb A1c水平较对照组下降明显,比较差异具有统计学意义(P<0.05);2组血糖控制达标率比较差异具有统计学意义(P<0.05);2组患者不良反应发生率比较差异无统计学意义(P>0.05),且不良反应予相应对症处理后可缓解或消失,均未出现低血糖等其他严重不良反应。结论西格列汀可明显降低单用二甲双胍血糖控制不达标老年T2DM患者的FPG、2h PG和Hb A1c,具有一定的安全性,可作为临床上治疗单用二甲双胍血糖不达标老年T2DM患者的优选治疗方案。

Objective To investigate the clinical eff icacy and safety of sitagliptin therapy in patients with type 2 diabetes mellitus(T2 DM) t reated with metformin alone. Methods 128 cases of elderly patients with T2 DM admitted to our hospital between January 2012 and May 2016, whose blood glucose levels were abnormal after a single metformin treatment, were selected as the subjects. The patients were equally divided into control group and observation group according to the treatment method. Patients in the control group were treated with metformin and pioglitazone, while the observation group was additionally treated with sitagliptin. The course of treatment was 3 months. The levels of blood glucose were compared between the two groups, and the incidence of adverse reactions was compared between the two groups after treatment. Results No signif icant difference was detected in FPG, 2 hPG, HbA1 c levels or BMI between the two groups before treatment(P>0.05). The above indexes were different after treatment, and the levels of FPG, 2 hPG and HbA1 c in the observation group were signif icantly lower than those in the control group, but BMI in the observation group was higher(P<0.05). The difference was statistically signif icant(P<0.05). No signif icant difference was detected in the incidence of adverse reactions between the two groups(P>0.05). The symptoms disappeared after cor responding treatment.No hypoglycemia or other serious adverse reactions occurred. Conclusion Sitagliptin can signif icantly reducethe FPG, 2 hPG and HbA1 c levels of elderly patients with T2 DM treated with metformin alone. Sitagliptin is quite safe and can be used as a treatment for patients with T2 DM.