达格列净与西格列汀治疗单用二甲双胍血糖控制不佳的2型糖尿病患者的效果的比较

Efficacy of dapagliflozin versus sitagliptin for type 2 diabetic patients with poor blood glucose control resulting from metformin monotherapy:a comparative study

目的比较达格列净与西格列汀治疗单用二甲双胍血糖控制不佳的2型糖尿病患者的效果。方法将单用二甲双胍治疗后血糖控制不佳的78例2型糖尿病患者,随机分为达格列净组和西格列汀组,每组39例。在二甲双胍治疗的基础上,达格列净组患者给予达格列净治疗,西格列汀组患者给予西格列汀治疗。比较两组患者治疗后血糖指标、脂质代谢指标、炎症因子水平以及药物不良反应发生率。结果治疗后,两组空腹血糖、空腹胰岛素、糖化血红蛋白,总胆固醇、三酰甘油、LDL-C,白细胞介素6、白细胞介素10、肿瘤坏死因子α水平均低于治疗前,HDL-C水平高于治疗前,且达格列净组上述指标改善均优于西格列汀组(均P<0.05)。两组患者治疗期间药物不良反应发生率差异无统计学意义(P>0.05)。结论单用二甲双胍治疗血糖控制不佳的2型糖尿病患者联合应用达格列净治疗可以更好地控制血糖,效果优于联合应用西格列汀。

Objective To compare the efficacy between dapagliflozin versus sitagliptin for type 2 diabetic patients with poor blood glucose control resulting from metformin monotherapy.Methods Seventy-eight type 2 diabetic patients with poor blood glucose control after metformin monotherapy were randomly divided into dapagliflozin group and sitagliptin group,with 39 cases in each group.Based on metformin therapy,patients in the dapagliflozin group were treated with dapagliflozin,and patients in the sitagliptin group were treated with sitagliptin.The levels of blood glucose indexes,lipid metabolism indexes and inflammatory factors,as well as the incidence rate of adverse drug reactions were compared between the two groups after treatment.Results After treatment,the levels of FBG,fasting insulin,hemoglobin A1 c,TC,TG,LDL-C,interleukin 6,interleukin 10 and tumor necrosis factorαwere decreased but HDL-C level was increased in both groups as compare with the levels before treatment,moreover,the improvements in the indexes described above in the dapagliflozin group were superior to those in the sitagliptin group(all P<0.05).There was no statistically significant difference in incidence rate of adverse drug reactions during treatment between the two groups(P>0.05).Conclusion For type 2 diabetic patients with poor blood glucose control resulting from metformin monotherapy,combination treatment with dapagliflozin can achieve better blood glucose control,and the efficacy is superior to that of combination treatment with sitagliptin.