沙格列汀或格列美脲联合甘精胰岛素对2型糖尿病患者的疗效比较

Effects comparison of salatrine or glimepiride combined with insulin glargine on treatment of patients with type 2 diabetes mellitus

目的探讨沙格列汀或格列美脲联合甘精胰岛素对2型糖尿病患者的疗效。方法选取2型糖尿病患者86例,按随机数字表法分为2组。对照组采用格列美脲+甘精胰岛素治疗;实验组采用沙格列汀+甘精胰岛素治疗,治疗前后采用72 h动态血糖检测仪测定血糖波动指标,记录胰岛素用量,采肘静脉血测定空腹胰岛素(FINS)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)、血清活性氧(ROS)、丙二醛(MDA)、超氧化物岐化酶(SOD)等指标,同时对比2组临床疗效及安全性指标。结果与治疗前比较,2组治疗后血糖标准差(SDBG)、平均血糖波动幅度(MAGE)、24 h血糖波动次数(NGE)及24 h血糖平均绝对差(MODD)显著降低,FINS显著升高,2 hPG、HbA1c显著降低,血清MDA、ROS水平显著降低,SOD水平显著升高(P<0.05)。与对照组比较,实验组治疗后SDBG、MAGE、NGE、MODD显著较低,FINS显著较高,2 hPG、HbA1c显著较低,血清MDA、ROS水平显著较低,SOD水平显著较高(P<0.05)。对照组有效率72.09%,显著低于实验组的90.70%(P<0.05)。结论与格列美脲比较,沙格列汀联合甘精胰岛素对2型糖尿病疗效确切,可有效控制血糖,改善血糖波动及氧化应激状态,且不增加其低血糖的发生风险。

Objective To investigate the effect of saxagliptin or glimepiride combined with insulin glargine on treatment of patients with type 2 diabetes mellitus.Methods Totally 86 patients with type 2 diabetes mellitus were selected and randomly divided into two groups.The control group was treated with glimepiride and insulin glargine,while the experiment group was treated with shagelline and insulin glargine.Before and after treatment,the blood glucose fluctuation index was measured by 72 h dynamic glucose test,and levels of FINS,2 hPG,HbA1c,MDA,ROS and SOD were measured.The clinical efficacy and safety indexes were compared.Results Compared with before treatment,the levels of SDBG,MAGE,NGE and MODD decreased significantly after treatment,the levels of FINS increased significantly,2 hPG and HbA1c decreased significantly after treatment,and the levels of serum MDA and ROS decreased significantly and SOD level increased significantly（P〈0.05）.Compared with the control group,the levels of SDBG,MAGE,NGE and MODD were significantly lower in the experiment group,and the levels of MDA and ROS were significantly lower,and the level of SOD was significantly higher（P〈0.05）.The effective rate was 72.09% in the control group,which was significantly lower than 90.70% in the experiment group（P〈0.05）.Conclusion Compared with glimepiride,saxagliptin combined with insulin glargine is effective in the treatment of patients with type 2 diabetes,it can effectively control blood sugar,improve blood sugar fluctuations and oxidative stress,and does not increase the risk of hypoglycemia.