甘精胰岛素联合SGLT-2抑制剂、DPP-4抑制剂治疗特定2型糖尿病患者疗效观察

Efficacy of insulin glargine combined with SGLT-2 inhibitor and Dpp-4 inhibitor in treatment of specific type 2 diabetes patients

目的探讨甘精胰岛素在治疗特定2型糖尿病患者时联合SGLT-2抑制剂、DPP-4抑制剂的疗效。方法选取2型糖尿病患者222例,随机分为对照组108例(甘精胰岛素+阿卡波糖),联合组114例(SGLT-2抑制剂+DPP-4抑制剂+甘精胰岛素),两组根据血糖水平调整两组甘精胰岛素剂量,主要终点:糖化血红蛋白(glycated hemoglobin,HbA1c)、空腹血糖(fasting blood glucose)、餐后2 h血糖(2-hour postprandial blood glucose);次要终点:体重指数、腰围臀围、血压、肝功、肾功电解质、血脂、胰岛素日剂量等。结果两组HbAlc、FPG、2 h PG均较治疗前明显下降(P<0.05),联合组在BMI、SBP、DBP、WC、UA、TG、胰岛素日剂量显著降低并且明显低于对照组(P<0.05)。结论甘精胰岛素在治疗特定2型糖尿病患者时联合SGLT-2抑制剂、DPP-4抑制剂,可平稳控制血糖,显著降低胰岛素日剂量、BMI,同时具有减小腰围、降压、降尿酸、调脂作用。

Objective To investigate the efficacy of insulin glycyrrhizin combined with SGLT-2 inhibitor and dipeptidyl peptidase-4 inhibitor in the treatment of specific type 2 diabetes mellitus.Methods A total of 222 patients with type 2 diabetes mellitus were randomly divided into control group(n=108)and combination group(n=114)(SGLT-2 inhibitor+DPP-4 inhibitor+insulin glargine).The dose of insulin glargine was adjusted according to the level of blood glucose in the two groups.The main end points were glycosylated hemoglobin(glycated hemoglobin,HbA 1 c),fasting blood glucose(fasting blood glucose)and postprandial blood glucose(2-hour postprandial blood glucose).Secondary endpoints:body mass index,waist circumference and hip circumference,blood pressure,liver function,kidney function and electrolytes,blood lipids,daily dose of insulin,etc.Results HbAlc,FPG and 2hPG in both groups were significantly lower than before treatment(P<0.05),and the daily doses of BMI,SBP,DBP,WC,UA,TG,and insulin in the combined group were significantly lower than those in the control group(P<0.05).Conclusion Insulin glargine combined with SGLT-2 inhibitor and DPP-4 inhibitor in the treatment of specific type 2 diabetic patients can steadily control blood glucose and significantly reduce the daily dosage of insulin.BMI,also has the effects of reducing waist circumference,lowering blood pressure,lowering uric acid and regulating blood lipid.