达格列净联合甘精胰岛素治疗2型糖尿病的有效性及安全性

Efficacy and safety of dapagliflozin combined with insulin glargine in treatment of type 2 diabetes mellitus

目的观察达格列净联合甘精胰岛素治疗2型糖尿病(T2DM)患者的有效性及安全性。方法选取2019年8月—2020年8月太仓市浏河人民医院收治的T2DM患者100例,根据治疗方案不同将其分为参照组和研究组,每组50例。参照组患者给予甘精胰岛素治疗,研究组患者给予达格列净联合甘精胰岛素治疗,2组患者均治疗10~14 d。比较2组治疗前后血糖指标〔空腹血糖(FPG)、餐后2 h血糖(2 hPBG)、糖化血红蛋白(HbA_(1c))〕、胰岛功能指标〔空腹C肽(FC-P)、胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)〕、体质指数(BMI),临床症状好转时间(血糖达标时间、尿酮体转阴时间)及治疗期间每日胰岛素使用量、低血糖发生率。结果治疗前2组FPG、2 hPBG、HbA_(1c)、FC-P、HOMA-IR、HOMA-β及BMI比较,差异无统计学意义(P>0.05);治疗后研究组FPG、2 hPBG、HbA_(1c)、HOMA-IR及BMI低于参照组,FC-P及HOMA-β高于参照组(P<0.05)。研究组血糖达标时间和尿酮体转阴时间短于参照组,治疗期间每日胰岛素使用量及低血糖发生率低于参照组(P<0.05)。结论达格列净联合甘精胰岛素治疗T2DM患者的临床疗效确切,可有效改善血糖指标、胰岛功能指标,降低BMI,减少胰岛素使用量,降低低血糖发生风险。

Objective To observe the efficacy and safety of dapagliflozin combined with insulin glargine in treatment of type 2 diabetes mellitus(T2DM).Methods A total of 100 patients with T2DM treated in Liuhe People's Hospital of Taicang City from August 2019 to August 2020 were selected.They were divided into reference group and study group according to different treatment schemes,with 50 cases in each group.The patients in the reference group were treated with insulin glargine,and the patients in the study group were treated with dapagliflozin combined with insulin glargine.Both groups were treated for 10-14 days.The blood glucose indexes(FPG,2 hPBG,HbA_(1c))and islet function indexes(FC-P,HOMA-IR and HOMA-β)and BMI before and after treatment,the improvement time of clinical symptoms(blood glucose reaching standard time,urine ketone body turning negative time),daily insulin use and the incidence of hypoglycemia during treatment were compared between the two groups.Results Before treatment,there was no significant difference in FPG,2 hPBG,HbA_(1c),FC-P,HOMA-IR,HOMA-βand BMI(P>0.05);after treatment,FPG,2 hPBG,HbA_(1c),HOMA-IR and BMI in the study group were lower than those in the reference group,FC-P and HOMA-βwere higher than those in the reference group(P<0.05).The blood glucose reaching standard time,urine ketone body turning negative time in the study group were shorter than those in the reference group,the daily insulin use and the incidence of hypoglycemia in the treatment group were lower than those in the reference group during treatment(P<0.05).Conclusion Dapagliflozin combined with insulin glargine has definite clinical effect in the treatment of T2DM patients.It can effectively improve blood glucose indexes and islet function indexes,reduce BMI,insulin use and the risk of hypoglycemia.