2型肥胖糖尿病患者应用胰岛素联合SGLT2抑制剂疗效和安全性研究

Study on the efficacy and safety of insulin combined with SGLT2 inhibitors in obese patients with type 2 diabetes mellitus

目的 观察胰岛素联合SGLT2抑制剂对2型肥胖糖尿病患者疗效及安全性的影响。方法 纳入2019年6月至2020年6月我院收治的2型肥胖糖尿病患者共120例,将所有研究对象随机分为联合组与单一组,每组各60例。单一组给予常规胰岛素治疗,联合组在单一组基础上给予SGLT2抑制剂,观察两组疗效、肥胖指标、血糖水平及安全性情况。结果 联合组临床总有效率为93.33%,高于单一组的71.67%,差异有统计学意义(P<0.05)。组内比较,两组BMI、WC指数、FBG、2 hPG、HbA1c水平均低于治疗前(P<0.05);组间比较,联合组BMI、WC指数、血糖各指标水平均低于单一组(P<0.05)。联合组不良反应总发生率为5.00%,低于单一组的30.00%,差异有统计学意义(P<0.05)。结论 胰岛素联合SGLT2抑制剂治疗2型肥胖糖尿病的疗效显著,可降低患者体质量指数、腰围及血糖水平,且安全性较高,值得临床广泛推广并应用。

Objective To observe the effect of insulin combined with SGLT2 inhibitor on the efficacy and safety in treating obese patients with type 2 diabetes mellitus.Methods A total of 120 obese patients with type 2 diabetes mellitus who were admitted to our hospital from June 2019 to June 2020 were enrolled.All subjects were randomly divided into the combination group and the single-therapy group,with 60 cases in each group.The single-therapy group was given conventional insulin treatment,while the combination group was given SGLT2 inhibitors on the basis of the same treatment as the single-therapy group.The efficacy,obesity indicators,blood glucose levels and safety of the two groups were observed.Results The total effective rate of clinical treatment in the combination group was 93.33%,wihch was higher than that of 71.67%in the single-therapy group,with statistically significant difference(P<0.05).According to the comparison within the groups,the BMI,WC index,FBG,2 hPG and HbA1 c levels of the two groups after treatment were lower than those before treatment(P<0.05).According to the comparison between groups,the levels of BMI,WC index,and blood glucose in the combination group were lower than those in the single-therapy group(P<0.05).The total incidence of adverse reactions in the combination group was 5.00%,which was lower than that of 30.00%in the single-therapy group,with statistically significant difference(P<0.05).Conclusion Insulin combined with SGLT2 inhi bitors has a significant effect on the treatment of obese patients with type 2 diabetes mellitus.It can reduce the patient′s body mass index,waist circumference and blood glucose level,with higher safety.It is worthy of widespread promotion and application in clinical practice.