达格列净干预2型糖尿病胰岛素治疗血糖控制不佳患者的临床疗效观察

Clinical efficacy of dapagliflozin in the treatment of type 2 diabetes with insulin in patients with poor glycemic control

目的探讨达格列净干预2型糖尿病胰岛素治疗血糖控制不佳患者的临床疗效。方法选取2017年9月至2018年4月济南市济钢医院收治的2型糖尿病患者70例,采用随机数字表法分为观察组和对照组,各35例。对照组接受胰岛素常规治疗或强化治疗联合2种或2种以上口服降糖药进行治疗,观察组同时给予达格列净(阿斯利康制药有限公司,国药准字J20170040)进行治疗(每日1次,每次10 mg,口服)。12周后,对比分析两组的空腹血糖(fasting plasma glucose,FPG)、餐后2 h血糖(2-hour postprandial blood glucose,2 hBG)、HbA1c、BMI、24 h尿糖、超敏CRP(hypersensitive CRP,hs-CRP)、尿酸(uric acid,UA)、TC、TG、HDL-C、LDL-C等指标,以及两组胰岛素日用量、低血糖发生次数等不良反应发生情况。结果治疗后,观察组FBG、HbA1c和2 hBG水平明显低于治疗前,且明显低于对照组(P<0.05);观察组BMI、胰岛素剂量、hs-CRP和UA水平明显低于治疗前,也低于对照组,24 h尿糖水平明显高于治疗前,也高于对照组(P<0.05)。两组治疗后HDL-C、LDL-C、TC和TG水平与治疗前相比,均无明显变化。观察组低血糖发生率明显低于对照组(P<0.05)。结论在血糖控制不佳的2型糖尿病患者中,联合服用达格列净能够有效控制血糖,减少胰岛素用量,且安全性较高。

Objective To investigate the clinical efficacy of dapagliflozin in the treatment of patients with type 2 diabetes with poor glycemic control.Methods Seventy patients with type 2 diabetes who were treated in our hospital from September 2017 to April 2018 were enrolled.All patients had HbA1 c levels≥7.0%.According to the random number table method,all patients were divided into observation group and control group,35 cases in each group.The control group received routine or intensive insulin treatment combined with two or more kinds of treatment,while the observation group was treated with dagglitazine at the same time.After 12 weeks,the FPG,HbA1 c,BMI,UA,daily insulin dosage as well as the incidence of adverse reactions(hypoglycemia)of the two groups were compared.Results After treatment,the levels of FBG,HbA1 c and 2 h BG in the observation group were significantly lower than those before treatment,and significantly lower than those of the control group(P<0.05).After treatment,HDL-C,LDL-C,TC and TG levels were not significantly different between the two groups and those before treatment.After treatment,the BMI,insulin dose,hs-CRP and UA levels in the observation group were significantly lower than those before treatment and those in the control group,and the 24 h urine sugar level was significantly higher than that before treatment and that in the control group(P<0.05).The incidence of hypoglycemia in the observation group was significantly lower than that in the control group(P<0.05).Conclusions In patients with type2 diabetes with poor glycemic control,the combination of dapagliflozin can effectively control blood sugar,reduce insulin dosage,and has high safety.