达格列净在类固醇性糖尿病患者中疗效及安全性分析

Effect and safety analysis of dapagliflozin combined with insulin therapy in patients with steroid diabetes mellitus

目的探讨达格列净在类固醇性糖尿病(SDM)患者中应用疗效并评估其安全性。方法选择本院就诊的30例SDM患者,随机平均分为两组:实验组与对照组。实验组使用达格列净+胰岛素降糖,对照组使用单纯胰岛素降糖。观察两组治疗效果及安全性。结果治疗前组间各指标无明显差异(P>0.05)。经3个月治疗后,两组间BMI、腰围、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)等有明显差异,(P<0.05),且实验组患者胰岛素日用量明显少于对照组(P<0.05),但两组间空腹血糖(FBG)、糖化血红蛋白(HbA1C)、肝功能、肌酐等比较均无明显差异(P>0.05)。实验组治疗后BMI、腰围、FBG、FINS、HOMAIR、HbA1C较治疗前均有明显改善(P <0.05),而肝功能、肌酐等较治疗前无明显差异(P> 0.05)。两组间不良反应发生率也无明显差异(P>0.05)。结论达格列净联合胰岛素治疗对SDM患者降糖作用明显,可改善患者胰岛素抵抗状态,帮助患者减轻体重负担。此外,达格列净没有加重肝肾功能损伤及其他严重不良反应。

Objective To evaluate the efficacy and safety of dapagliflozin in patients with steroid diabetes mellitus(SDM).Methods 30 cases of patients with SDM were randomly divided into two groups: experimental group and control group. The experimental group were treated with dapagliflozin and insulin to control blood sugar, while the contrast group only were treated with insulin. The efficacy and safety between the two groups were observed. Results All the observation indexes had no significant differences between the two groups before the treatment(P > 0.05). After 3 months of treatment, there were significant differences between the two groups in BMI,waistline, fasting insulin(FINS)and insulin resistance index(HOMA-IR)(P < 0.05), and the daily dose of insulin in the observation group was significantly lower than that in the control group(P < 0.05). However, there were no significant differences between the two groups in fasting blood glucose(FBG), glycated hemoglobin(HbA1C), liver function and creatinine(P>0.05). BMI, waistline, FBG, FINS,HOMA-IR and HbA1C were all significantly improved after treatment(P<0.05), but there were no significant differences in liver function and creatinine after treatment(P>0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P > 0.05). Conclusions Dapagliflozin combined with insulin can significantly reduce glucose in SDM patients, improve insulin resistance, and help patients to reduce weight. In addition, dapagliflozin would not cause liver and kidney damage or lead to other serious adverse events.