西格列汀联合胰岛素对老年2型糖尿病患者血糖波动系数及低血糖发生率的影响

Effects of sitagliptin combined with insulin on the blood glucose fluctuation coefficient and the incidence of hypoglycemia in elderly patients with type 2 diabetes

目的观察西格列汀联合胰岛素对老年2型糖尿病患者血糖波动系数及低血糖发生率的影响。方法选取2018年10月-2019年6月广州市白云区人民医院内二科接诊的老年2型糖尿病患者100例,根据治疗方案的不同分为观察组与对照组各50例。对比2组治疗前后血糖、胰岛功能指标、血糖波动情况及低血糖发生率。结果治疗后,2组空腹血糖(FPG)、糖化血红蛋白(HbA1c)水平均低于治疗前,空腹C肽水平均高于治疗前,且观察组变化幅度大于对照组(P <0.01)。治疗后,2组患者血糖波动系数(BGFC)、平均血糖(MBG)及日内血糖平均波动幅度(MAGE)水平均低于治疗前,且观察组患者BGFC、MBG及MAGE水平均低于对照组(P <0.01)。观察组患者治疗后低血糖发生率为2.00%,低于对照组患者的16.00%(χ^(2)=4.396,P=0.014)。结论西格列汀联合胰岛素治疗老年2型糖尿病可有效降低血糖,提高胰岛功能,缓解血糖波动情况。

Objective To observe the effect of sitagliptin combined with insulin on the glycemic fluctuation coefficient and the incidence of hypoglycemia in elderly patients with type 2 diabetes. Methods A total of 100 elderly patients with type 2 diabetes who were admitted to the second department of Guangzhou Baiyun District People’s Hospital from October 2018 to June 2019 were selected. According to different treatment regimens,the patients were divided into observation group and control group with 50 cases each. Blood glucose,islet function,blood glucose fluctuation and incidence of hypoglycemia were compared between the 2 groups before and after treatment. Results After treatment,the fasting plasma glucose( FPG),glycosylated hemoglobin( Hb A1 c) levels of two groups were lower than before the treatment,fasting C peptide levels were higher than before the treatment,and observation group changed more than the control group,the fasting C-peptide levels was higher than the control group( P < 0. 01). After treatment,the blood sugar fluctuation coefficient( BGFC),the average blood sugar( MBG) and days average blood glucose fluctuation amplitude( MAGE) levels of two groups were lower than before the treatment,and observation group was lower than control group( P < 0. 01). After treatment,observation group in patients with hypoglycemia incidence was 2. 00%,lower than 16. 00% in the control group( χ2= 4. 396,P = 0. 014). Conclusion The combination of sitagliptin and insulin in the treatment of senile type 2 diabetes can effectively reduce blood glucose,improve islet function,and alleviate the fluctuation of blood glucose.