利格列汀联合地特胰岛素对磺脲类药物继发治疗失效2型糖尿病患者血糖控制的影响

Effect of linagliptin combined with insulin detemir on blood glucose control in type 2 diabetic mellitus patients with secondary failure to sulfonylureas

目的分析利格列汀+地特胰岛素在磺脲类药物继发治疗失效2型糖尿病(T2DM)中的应用价值。方法前瞻性选取2019年1月至2020年12月我院82例磺脲类药物继发治疗失效T2DM患者,随机数字表法分组,均给予常规干预。单一组41例以地特胰岛素治疗,联合组41例以利格列汀+地特胰岛素治疗。比较两组疗效、治疗前后空腹血糖(FPG)、糖化血红蛋白(HbA1c)、餐后2 h血糖(2 hPG)、空腹C肽(CP)、餐后2 hC肽(2 hCP)水平、不良反应发生率。结果联合组总有效率为92.68%,高于单一组的73.17%,治疗后FPG(7.12±0.68)mmol/L、HbA1c(7.16±1.12)%、2 hPG(9.34±1.45)mmol/L,低于单一组的(8.01±0.96)mmol/L、(8.05±1.30)%、(10.29±1.67)mmol/L,CP(0.65±0.08)nmol/L、2 hCP(2.10±0.28)nmol/L,高于单一组的(0.57±0.10)nmol/L、(1.87±0.30)nmol/L,差异有统计学意义(P<0.05);两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论利格列汀+地特胰岛素对磺脲类药物继发治疗失效T2DM效果显著,可有效改善胰岛β细胞功能,控制血糖水平,且能保证用药安全性。

Objective To analyze the application value of linagliptin+insulin detemir in the treatment of patients with type 2 diabetes mellitus(T2DM)and secondary failure to sulfonylureas.Methods A total of 82 T2DM patients with secondary failure to sulfonylureas in our hospital from January 2019 to December 2020 were prospectively selected and grouped by a random number table,and routine interventions were given.41 cases in the single-therapy group were treated with insulin detemir,and 41 cases in the combination group were treated with linagliptin+insulin detemir.The efficacy,levels of fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),2 h postprandial plasma glucose(2 hPG),fasting C-peptide(CP),2 h postprandial C-peptide(2 hCP),and incidence of adverse reactions were compared between the two groups before and after treatment.Results The total effective rate in the combination group(92.68%)was higher than that in the single-therapy group(73.17%).After treatment,the levels of FPG,HbA1c and 2 hPG in the combination group[(7.12±0.68)mmol/L,(7.16±1.12)%,(9.34±1.45)mmol/L]were lower than those in the single-therapy group[(8.01±0.96)mmol/L,(8.05±1.30)%,(10.29±1.67)mmol/L].The levels of CP and 2 hCP in the combination group[(0.65±0.08)nmol/L,(2.10±0.28)nmol/L]were higher than those in the single-therapy group[(0.57±0.10)nmol/L,(1.87±0.30)nmol/L],with statistically significant differences(P<0.05).There was no statistically significant difference in terms of total incidence of adverse reactions between the two groups(P>0.05).Conclusion The effect of linagliptin combined with insulin detemir is significant in the treatment of T2DM patients with secondary failure to sulfonylureas.It can effectively improve the function of pancreaticβ-cells,control blood glucose levels and ensure medication safety.