沙格列汀联合早期胰岛素泵强化治疗对初诊2型糖尿病患者血糖水平及胰岛β细胞功能的影响研究

Effect of saxagliptin combined with early insulin intensive pump therapy on blood glucose level and islet β cell function in newly diagnosed type 2 diabetes mellitus patients

目的探讨沙格列汀联合早期胰岛素泵强化治疗对初诊2型糖尿病患者血糖水平及胰岛β细胞功能的影响。方法103例初诊2型糖尿病患者,根据降糖治疗方式不同分为泵组(51例)和联合组(52例)。泵组给予早期胰岛素泵强化治疗,联合组在泵组基础上加用沙格列汀治疗。比较两组患者治疗前后的空腹血糖、餐后2 h血糖、糖化血红蛋白、胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)、C肽水平。结果治疗后,两组患者的空腹血糖、餐后2 h血糖、糖化血红蛋白水平均低于本组治疗前,差异具有统计学意义(P<0.05)。联合组患者治疗后的HOMA-IR(2.0±0.4)低于本组治疗前的(3.1±0.6)及泵组治疗后的(2.8±0.6),差异具有统计学意义(P<0.05);两组患者治疗后的HOMA-β水平均高于本组治疗前,差异具有统计学意义(P<0.05)。两组患者餐后2 h的C肽水平均高于本组治疗前,且联合组患者餐后2 h的C肽(8.1±2.1)ng/ml高于泵组的(6.0±1.6)ng/ml,差异具有统计学意义(P<0.05)。结论初诊2型糖尿病患者采用沙格列汀联合早期胰岛素泵强化治疗的效果显著,可以改善胰岛β细胞生理分泌能力和病理损伤程度,降低血糖水平,建议临床首选。

Objective To discuss the effect of saxagliptin combined with early insulin intensive pump therapy on blood glucose level and islet β cell function in newly diagnosed type 2 diabetes mellitus patients.Methods A total of 103 newly diagnosed type 2 diabetes mellliuts patients were divided into pump group(51 cases)and combined group(52 cases)according to different hypoglycemic treatment methods.The pump group was given early insulin pump intensive therapy,and the combined group was given saxagliptin on the basis of the pump group.Both group were compared in terms of fasting blood glucose,2 h postprandial blood glucose,glycosylated hemoglobin,homeostasis model assessment of insulin resistance(HOMA-IR),homeostasis model assessment of β-cell function(HOMA-β),and C-peptide before and after treatment.Results After treatment,the levels of fasting blood glucose,2 h postprandial blood glucose,and glycosylated hemoglobin in the two groups were lower than those before treatment in this group,and the difference was statistically significant(P<0.05).After treatment,the HOMA-IR(2.0±0.4)in the combined group was lower than(3.1±0.6)before treatment in this group and(2.8±0.6)after treatment in the pump group,and the difference was statistically significant(P<0.05).After treatment,the levels of HOMA-β in the two groups were higher than those before treatment in this group,and the difference was statistically significant(P<0.05).The levels of 2 h postprandial C-peptide in both groups were higher than those before treatment in this group,and the 2 h postprandial C-peptide(8.1±2.1)ng/ml in the combined group were higher than(6.0±1.6)ng/ml in the pump group.All the differences were statistically significant(P<0.05).Conclusion Saxagliptin combined with early insulin intensive pump therapy has a good therapeutic effect on newly diagnosed type 2 diabetes mellitus patients,which can improve the physiological secretion capacity and pathological damage of pancreaticβcells,and reduce blood glucose levels.It is recommended for clinical practice.