门冬胰岛素30联合维格列汀治疗二甲双胍血糖控制效果不佳的2型糖尿病患者的临床效果分析

Insulin aspart 30 combined with vildagliptin in the treatment of type 2 diabetes mellitus patients with poor glycemic control of metformin:an analysis of the clinical effects

目的探讨门冬胰岛素30联合维格列汀治疗二甲双胍血糖控制效果不佳的2型糖尿病(T2DM)患者的临床效果。方法选取2019年1月至2020年5月在本院诊治的二甲双胍血糖控制效果不佳的T2DM患者102例为研究对象,采用随机数字法分为研究组(52例)和对照组(50例)。对照组患者给予门冬胰岛素30治疗,研究组患者给予门冬胰岛素30联合维格列汀治疗,疗程3个月。检测比较两组患者治疗前后的空腹血糖(FBG)、餐后2小时血糖(2hPG)、糖化血红蛋白(HbA1c)水平;检测比较两组患者的胰岛功能和肾功能;比较两组患者的平均每天胰岛素用量和低血糖发生情况。结果治疗3个月后,研究组患者的FBG、2hPG、HbA1c水平明显低于对照组,胰岛β细胞功能(HOMA-β)明显优于对照组,空腹胰岛素(FINS)、胰岛素抵抗(HOMA-IR)水平显著低于对照组,血尿酸(UA)、血肌酐(SCr)水平明显低于对照组,平均每天胰岛素用量明显少于对照组,差异均有统计学意义(P<0.05);两组患者的低血糖发生率均较低,组间差异无统计学意义(P>0.05)。结论门冬胰岛素30联合维格列汀治疗二甲双胍血糖控制效果不佳的2型糖尿病患者的临床效果显著,可有效控制血糖水平、降低胰岛素用量、改善患者胰岛功能和肾脏功能,患者的低血糖发生率较低,值得推广应用。

Objective To explore the clinical effects of insulin aspart 30 combined with vildagliptin in the treatment of type 2 diabetes mellitus(T2DM)patients with poor glycemic control of metformin.Methods A total of 102 T2DM patients with poor glycemic control of metformin who were diagnosed and treated in our hospital from January 2019 to May 2020 were selected as the research objects,and they were divided into study group(52 cases)and control group(50 cases)by the random number method.Patients in the control group were treated with insulin aspart 30,while patients in the study group were treated with insulin aspart 30 combined with vildagliptin,for a 3-month treatment course.The levels of fasting blood glucose(FBG),2 hours postprandial blood glucose(2hPG)and glycosylated hemoglobin(HbA1c)were detected and compared between the two groups before and after treatment.The islet function,renal function,the average daily dosage of insulin and incidence of hypoglycemia were compared between the two groups.Results The levels of FBG,2hPG and HbA1c,fasting insulin(FINS),insulin resistance(HOMA-IR),blood uric acid(UA),serum creatinine(SCr)and the average daily dosage of insulin in the study group were significantly lower than those in the control group,with statistically significant differences(P<0.05).Isletβcell function(HOMA-β)in the study group was significantly better than that in the control group,with a statistically significant difference(P<0.05).The incidence of hypoglycemia was low in both groups without statistically significant difference(P>0.05).Conclusion The clinical effects of insulin aspart 30 combined with vildagliptin in the treatment of type 2 diabetes mellitus patients with poor glycemic control of metformin are remarkable,with effective control of blood glucose levels,reduction of insulin dosage,improvement of islet function and kidney function in patients,and the low incidence of hypoglycemia in patients,which is worthy of popularization and application.