地特胰岛素联合二甲双胍对老年新发2型糖尿病的治疗效果分析

Treatment Effect Analysis of Insulin Detemir combined with Metformin on Elderly Patients with New Onset Type 2 Diabetes

目的:观察地特胰岛素联合二甲双胍对老年新发2型糖尿病的治疗效果,为临床用药选择提供数据支持。方法:纳入并分析2015年至2016年我院收治的老年新发2型糖尿病患者的临床资料。依据治疗方案的不同分为观察组(二甲双胍联合地特胰岛素)及对照组(二甲双胍)。治疗6个月后,比较两组总胆固醇(TC)、低密度脂蛋白(LDL-c)、甘油三脂(TG)、白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)及白介素-10(IL-10)、糖化血红蛋白(Hb A1c)、胰岛素抵抗指数(HOMA-IR)及胰岛β细胞功能指数(HOMA-β)的改变。结果:共纳入观察组45例,对照组50例。治疗后,两组患者Hb A1c及HOMA-IR均显著降低(P<0.05),但观察组显著低于对照组(P<0.05);治疗后两组HOMA-β均显著升高(P<0.05),而观察组高于对照组患者的水平(P<0.05)。治疗后,两组患者TG、TC及LDL-C水平均降低(P<0.05),但观察组低于对照组(P<0.05)。治疗前后两组患者IL-10水平比均未见显著改变(P>0.05)。经治疗,两组IL-8及TNF-α水平均降低(P<0.05),同时观察组低于对照组(P<0.05)。结论:在老年新发2型糖尿病的治疗中,地特胰岛素联合二甲双胍的临床疗效优于单独使用二甲双胍。

Objective:To observe the effect of insulin detemir combined with metformin on elderly patients with new onset type 2 diabetes treatment,in order to provide reference for clinical diagnosis and treatment.Methods:The clinical data of elderly patients with newly diagnosed type 2 diabetes in our hospital during the past 2015 to 2016 years were included and analyzed.The patients were divided into observation group(metformin combined with insulin detemir)and control group(metformin).Six months after treatment,total cholesterol(TC),low density lipoprotein(LDL-c),triglyceride(TG),interleukin-8(IL-8),tumor necrosis factor-alpha(TNF-α),interleukin-10(IL-10),glycosylated hemoglobin(HbA1c),insulin resistance index(HOMA-IR)and islet beta cell function index(HOMA-IR)were compared between the two groups.Changes in beta.Results:45 cases were included in the observation group and 50 cases in the control group.After treatment,both HbA1c and HOMA-IR in the two groups were significantly decreased(P<0.05),but the observation group was significantly lower than the control group(P<0.05).After treatment,the levels of HOMA-βin both groups were significantly higher than those in the control group(P<0.05).After treatment,the levels of TG,TC and LDL-C were decreased in both groups(P<0.05),but those in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of IL-8 and TNF-αin both groups were decreased(P<0.05),while those in the observation group were lower than those in the control group(P<0.05).Conclusion:In the treatment of new type 2 diabetes mellitus in the elderly,insulin detemir combined with metformin is better than metformin alone.