达格列净联合胰岛素治疗2型糖尿病的疗效及安全性观察

Clinical efficacy and safety of dapagliflozin combined with insulin in the treatment of type 2 diabetes mellitus

目的:探讨采用达格列净联合胰岛素治疗2型糖尿病的临床效果。方法:抽取2017年12月至2019年10月太原钢铁(集团)有限公司总医院收治的2型糖尿病患者83例,按照随机对照原则将其分为观察组(45例,采用胰岛素联合达格列净治疗)和对照组(38例,采用胰岛素联合安慰剂治疗),对两组患者血糖控制效果、胰岛功能等指标的变化情况进行观察分析。结果:观察组患者血糖达标所用时间[(4.5±1.7)d]短于对照组[(6.6±2.4)d],且观察组患者血糖达标时的胰岛素用量[(24.2±8.4)U]、糖化血红蛋白水平[(9.1±1.9)%]均低于对照组[(31.5±9.7)U,(10.5±2.3)%],差异有统计学意义(P<0.05);观察组患者血糖达标时胰岛素抵抗指数(1.51±0.83)低于对照组(1.86±0.77),差异有统计学意义(P<0.05);两组患者治疗期间低血糖等不良反应发生情况比较差异未见统计学意义(P>0.05)。结论:采用达格列净联合胰岛素对2型糖尿病患者进行治疗,可有效增强血糖控制效果,提高机体胰岛素敏感性,对于减少胰岛素用量,提高治疗安全性具有十分积极的作用。

Objective To investigate the clinical effects of dapagliflozin combined with insulin in the treatment of type 2 diabetes mellitus.Methods A total of 83 patients with type 2 diabetes mellitus admitted to General Hospital of Taiyuan Iron and steel(Group)Co.,Ltd.from December 2017 to October 2019 were selected,and they were divided into observation group(45 cases,treated with insulin combined with dapagliflozin)and control group(38 cases,treated with insulin combined with placebo)according to the principle of randomized control.The changes of blood glucose control effect,islet function and other indicators of the two groups were observed and analyzed.Results The time of blood glucose reaching the standard in the observation group was(4.5±1.7)d,shorter than the(6.6±2.4)d in the control group,while the insulin consumption and HbAlc level of the observation group were(24.2±8.4)U and(9.1±1.9)%respectively,significantly lower than the(31.5±9.7)U and(10.5±2.3)%of the control group,and the difference was statistically significant(P<0.05).The Homeostatic model assessment for insulin resistance(HOMA-IR)value of the observation group(1.51±0.83)was lower than that of the control group(1.86±0.77)when the blood glucose reached the standard(P<0.05).There was no significant difference in the occurrence of adverse reactions,for example hypoglycemia,during treatment between the two groups(P>0.05).Conclusions The use of dapagliflozin combined with insulin in the treatment of patients with type 2 diabetes mellitus can effectively enhance the blood glucose control effect and improve the insulin sensitivity,which has a very positive effect on reducing the usage of insulin and improving the safety of treatment.