地特胰岛素联合伏格列波糖治疗老年T2DM患者早期糖尿病肾病的疗效研究

Study on the efficacy of insulin detemir combined with voglibose in the treatment of elderly T2DM patients with early diabetic nephropathy

目的了解地特胰岛素联合伏格列波糖对新诊断老年2型糖尿病(T2DM)患者早期糖尿病肾病的疗效。方法选取该院住院的91例合并糖尿病肾病的新诊断老年T2DM患者,分为观察组(予以地特胰岛素联合伏格列波糖片,46例)和对照组(予以格列美脲联合伏格列波糖片,45例),治疗12周。评价两组空腹血糖(FPG)、餐后2 h血糖(2 h PPG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、胰岛β细胞功能指数(HOMA-β)、24 h尿微量清蛋白排泄率(UAER),同时评估两组服药期间低血糖发生情况。结果治疗后两组HbA1c、FPG、2 h PPG、UAER水平明显低于治疗前,观察组降低更明显(P<0.05)。经过多变量校正后,干预后观察组UAER仍呈明显下降(P<0.05)。与对照组比较,治疗后观察组FINS、HOMA-β明显改善(P<0.05)。两组治疗中并未发生严重低血糖事件,观察组低血糖发生率与对照组比较(8.9%vs.15.2%),差异无统计学意义(P>0.05)。结论地特胰岛素联合伏格列波糖对新诊断老年T2DM患者早期糖尿病肾病的疗效较好。

Objective To understand the efficacy of insulin detemir combined with voglibose on early diabetic nephropathy in newly diagnosed elderly type 2 diabetes mellitus(T2DM)patients.Methods A total of 91 newly diagnosed elderly T2DM patients with diabetic nephropathy who were hospitalized were divided into the observation group(insulin detemir with voglibose tablets,46 cases),and the control group(Glimepiride combined with voglibose tablets,45 cases).All the patients were followed up for 12 weeks.The between-group differences of fasting plasma glucose(FPG),postprandial 2-hour plasma glucose(2 h PPG),glycated hemoglobin(HbA1c),fasting insulin(FINS),isletβ-cell function index(HOMA-β),and 24-hour urine microalbumin excretion rate were evaluated.Moreover,the occurrence of hypoglycemia duringthe medication administration were compared between groups.Results After treatment,the levels of HbA1c,FPG,2 h PPG and UAER in the two groups were significantly lower than those before treatment,and the observation group decreased more significantly(P<0.05).After multivariate adjustment,the UAER of the observation group still decreased significantly after the intervention(P<0.05).Compared with the control group,FINS and HOMA-βin the observation group were significantly improved after treatment(P<0.05).No serious hypoglycemia event occurred in the two treatment groups.Compared with the control group,the incidence of hypoglycemia in the observation group(8.9%vs.15.2%)was not statistically significant(P>0.05).Conclusion Insulin detemir combined with voglibose is effective in treating early diabetic nephropathy in newly diagnosed elderly T2DM patients.