达格列净联合胰岛素治疗2型糖尿病的效果及其对血糖波动的影响

The Effect of Dapagliflozin Combined with Insulin in the Treatment of Type 2 Diabetes and Its Influence on Blood Glucose Fluctuation

目的研究达格列净联合胰岛素治疗2型糖尿病的效果。方法选择2019年3月—2021年2月收治的89例2型糖尿病患者作为该次研究对象,随机抽签法将患者分为两组,对照组44例接受胰岛素治疗,观察组45例接受达格列净联合胰岛素治疗,比较两组血糖波动情况、不同时间点血糖水平、低血糖事件发生情况。结果观察组治疗10 d后全天平均血糖(MBG)、血糖水平标准(SDBG)、最大血糖波动幅度(LAGE)、餐后血糖波动幅度(PPGE)水平分别为(8.12±1.62)、(1.75±0.67)、(3.42±0.67)、(2.61±0.53)mmol/L,均低于对照组(10.51±2.34)、(2.74±0.79)、(4.95±0.81)、(3.64±0.58)mmol/L,差异有统计学意义(t=5.613、6.381、9.719、8.749,P<0.05)。观察组治疗10 d后三餐前、三餐后2 h、夜间3点的血糖水平均低于对照组,差异有统计学意义(t=5.463、6.050、9.714、5.990、8.994、10.162、5.477,P<0.05)。观察组治疗期间症状性、无症状性低血糖事件发生率4.44%、2.22%,对照组发生率分别为2.27%、2.27%,差异无统计学意义(P>0.05)。结论达格列净联合胰岛素治疗2型糖尿病的效果良好,可有效控制各个时间点的血糖水平,减小血糖波动,且不会明显增加低血糖事件,安全性良好。

Objective To study the effect of dapagliflozin combined with insulin in the treatment of type 2 diabetes.Methods From March 2019 to February 2021,89 patients with type 2 diabetes were selected as the subjects of this study.The patients were divided into two groups by a random lottery method.44 patients in the control group received insulin treatment,and 45 patients in the observation group received dapagliflozin combined insulin therapy,compared the blood glucose fluctuations,blood glucose levels at different time points,and the occurrence of hypoglycemia events between the two groups.Results The levels of MBG,SDBG,LAGE,and PPGE in the observation group after 10 d of treatment were(8.12±1.62)mmol/L,(1.75±0.67)mmol/L,(3.42±0.67)mmol/L,(2.61±0.53)mmol/L,all lower than the control group(10.51±2.34)mmol/L,(2.74±0.79)mmol/L,(4.95±0.81)mmol/L,(3.64±0.58)mmol/L,and the difference was statistically significant(t=5.613,6.381,9.719,8.749,P<0.05).The blood glucose levels of the observation group before three meals,2 h after three meals,and 3 o'clock at night after 10 days of treatment were lower than those of the control group,and the difference was statistically significant(t=5.463,6.050,9.714,5.990,8.994,10.162,5.477,P<0.05).The incidence of symptomatic and asymptomatic hypoglycemia during treatment in the observation group was 4.44%and 2.22%,and the incidence in the control group was 2.27%and 2.27%,respectively,and the difference was not statistically significant(P>0.05).Conclusion Dapagliflozin combined with insulin has a good effect in the treatment of type 2 diabetes.It can effectively control blood glucose levels at various time points,reduce blood glucose fluctuations,and will not significantly increase hypoglycemia events,and has good safety.