磷酸西格列汀联合甘精胰岛素治疗老年2型糖尿病患者的效果

Effects of Insulin glargine combined with Sitagliptin phosphate in treatment of elderly patients with type 2 diabetes mellitus

目的:观察磷酸西格列汀联合甘精胰岛素治疗老年2型糖尿病(T2DM)患者的效果。方法:选取86例老年T2DM患者为研究对象,按照随机数字表法分为对照组和观察组各43例。对照组采用甘精胰岛素治疗,观察组在对照组基础上联合磷酸西格列汀治疗,比较两组治疗前后糖代谢指标[空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)]水平、C肽水平、炎性因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]水平和低血糖发生率。结果:治疗后,两组FPG、2hPG、HbA1c、HOMA-IR、IL-6、TNF-α和CRP水平均低于治疗前,且观察组低于对照组,两组C肽水平均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);两组低血糖发生率比较,差异无统计学意义(χ^(2)=0.262,P=0.609)。结论:磷酸西格列汀联合甘精胰岛素治疗T2DM患者,可降低糖代谢指标水平和炎性因子水平,提高C肽水平,优于单纯甘精胰岛素治疗效果。

Objective:To explore effects of Insulin glargine combined with Sitagliptin phosphate in treatment of elderly patients with type 2 diabetes mellitus(T2DM).Methods:86 elderly patients with T2DM were selected as the research objects,and were divided into control group and observation group according to the random number table method,43 cases in each group.The control group was treated with Insulin glargine,while the observation group was treated with Sitagliptin phosphate on the basis of that of the control group.The glucose metabolism indexes[fasting blood glucose(FPG),2 h postprandial blood glucose(2hPG),glycosylated hemoglobin(HbA1c),homeostasis model assessment-insulin resistance(HOMA-IR)]levels,the C-peptide level,the inflammatory factors[interleukin-6(IL-6)],tumor cell necrosis factor-α(TNF-α),C-reactive protein(CRP)]levels and the incidence of hypoglycemia were compared between the two groups before and after the treatment.Results:After the treatment,the levels of FPG,2hPG,HbA1c,HOMA-IR,IL-6,TNF-αand CRP in the two groups were lower than those before the treatment,and those of the observation group were lower than those of the control group;the C-peptide level of the two groups were higher than those before the treatment,and that of the observation group was higher than that of the control group;and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of hypoglycemia between the observation group and control group(χ^(2)=0.262,P=0.609).Conclusions:Insulin glargine combined with Sitagliptin phosphate in the treatment of the T2DM patients can reduce the glucose metabolism index levels and the inflammatory factor levels,and increase the C-peptide level.Moreover,it is superior to single Insulin glargine.