沙格列汀对2型糖尿病患者平均血糖波动幅度、HOMA表达、β细胞功能的影响

Effect of Saxagliptin on the Mean Blood Glucose Fluctuation Range,HOMA Expression andβ-cell Function in Patients with Type 2 Diabetes Mellitus

目的评价沙格列汀对2型糖尿病患者血糖波动的调节作用。方法将145例患者随机分为3组,沙格列汀低剂量(SG-L)组、沙格列汀高剂量(SG-H)组、二甲双胍(MG)组,分别给予二甲双胍1500mg+沙格列汀2.5mg、二甲双胍1 500 mg+沙格列汀5 mg、二甲双胍(1 500~2 000 mg)进行治疗。干预后检测其血糖水平、动态血糖及胰岛功能。结果治疗后,与MG组相比,SG-H组在早餐后2 h、午餐前、午餐后2 h、晚餐前、晚餐后2 h及晚餐后4 h血糖明显降低(P<0.05);平均血糖波动幅度、血糖水平标准差、最大血糖波动幅度、平均血糖水平明显降低(P<0.05);胰岛素β功能指数明显升高,胰岛素抵抗指数、空腹胰岛素水平均明显降低(P<0.05)。结论沙格列汀联合二甲双胍能有效控制不同时间点患者血糖,减少患者血糖波动,同时改善胰岛素β细胞功能,改善2型糖尿病患者的胰岛素抵抗。

OBJECTIVE To evaluate the effect of saxagliptin on the regulation of blood glucose fluctuations in patients with type 2 diabetes mellitus.METHODS One hundred forty-five patients were randomly divided into 3 groups,saxagliptin low-dose(SG-L)group,saxagliptin high-dose(SG-H)group,and metformin(MG)group,gave metformin 1500 mg+saxagliptin 2.5 mg,metformin 1500 mg+saxagliptin 5 mg,and metformin(1500−2000 mg),respectively.The glucose level,dynamic glucose and pancreas islet function were measured.RESULTS After treatment,compared with the MG group,the blood glucose of the SG-H group was significantly reduced 2 h after breakfast,before lunch,2 h after lunch,and before dinner,2 h after dinner and 4 h after dinner(P<0.05);mean blood glucose fluctuation range,standard deviation of blood glucose level,maximum blood glucose fluctuation range,the mean blood glucose level value was significantly reduced(P<0.05);HOMA-βlevels was significantly increased,HOMA-IR and fasting insulin levels were reduced significant(P<0.05).CONCLUSION Saxagliptin combined with metformin can effectively control glucose in patients at different time points,reduce glucose fluctuation,while improving insulinβ-cell function,improving insulin resistance in patients with type 2 diabetes mellitus.