达格列净联合沙格列汀治疗二甲双胍控制不佳的2型糖尿病患者的效果观察

Effect of Dapagliflozin Combined with Saxagliptin on Patients with Metformin Poorly Controlled Type 2 Diabetes Mellitus

目的:探讨达格列净联合沙格列汀治疗二甲双胍控制不佳的2型糖尿病(T2DM)患者的效果。方法:选择2019年1月-2020年12月辽阳市第二人民医院收治的84例二甲双胍控制不佳的T2DM患者,采用随机数字表法将其分为对照组与观察组,每组42例。两组均给予二甲双胍治疗,观察组加用达格列净联合沙格列汀,对照组加用格列美脲,两组均连续治疗24周。比较两组治疗前后体重、空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)、收缩压(SBP)、舒张压(DBP)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、血尿酸(UA)、血肌酐(Scr)水平及不良反应发生情况。结果:观察组治疗后体重较治疗前下降,且低于对照组(P<0.05);对照组治疗前后体重比较,差异无统计学意义(P>0.05)。观察组治疗后体重减少≥5%者占比为26.19%(11/30)高于对照组的2.38%(1/30),差异有统计学意义(P<0.05)。治疗后,两组FPG、2 h PG、HbA1c均较治疗前下降,且观察组均优于对照组(P<0.05)。观察组治疗后HbA1c<7.0%者占比为59.52%(25/30)高于对照组的35.71%(15/30),差异有统计学意义(P<0.05)。治疗后,观察组TC、TG均低于治疗前,且TG低于对照组(P<0.05)。观察组治疗后SBP、DBP均低于对照组和治疗前(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:与格列美脲相比,在二甲双胍控制不佳T2DM患者中,同时添加达格列净及沙格列汀可显著改善血糖、体重及TG水平,且并未明显增加不良反应。

Objective:To investigate the effect of Dapagliflozin combined with Saxagliptin on patients with Metformin poorly controlled type 2 diabetes mellitus(T2DM).Method:A total of 84 patients with Metformin poorly controlled T2DM treated in Liaoyang Second People’s Hospital from January 2019 to December 2020 were selected.They were divided into control group and observation group by random number table method,with 42 cases in each group.Both groups were treated with Metformin,the observation group was added with Dapagliflozin combined with Saxagliptin,and the control group was added with Glimepiride.Both groups were treated for 24 weeks.Body weight,fasting blood glucose(FPG)and 2 h postprandial blood glucose(2 h PG),glycosylated hemoglobin(HbA1c),systolic blood pressure(SBP),diastolic blood pressure(DBP),total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),blood uric acid(UA),blood creatinine(Scr)and the incidence of adverse reactions.Result:The body weight of observation group was lower than that of control group after treatment(P<0.05);there was no significant difference in body weight of the control group before and after treatment(P>0.05).The proportion of weight loss≥5%in the observation group was 26.19%(11/30),which was higher than 2.38%(1/30)in the control group,and the difference was statistically significant(P<0.05).After treatment,FPG,2 h PG and HbA1c in two groups were decreased compared with before treatment,and observation group were better than those in control group(P<0.05).After treatment,the proportion of HbA1c<7.0%in the observation group was 59.52%(25/30)higher than 35.71%(15/30)in the control group,and the difference was statistically significant(P<0.05).After treatment,TC and TG in observation group were lower than those before treatment,and TG was lower than that of control group(P<0.05).The SBP and DBP of observation group after treatment were lower than those of control group and before treatment(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Compared with Glimepiride,the Dapagliflozin combined with Saxagliptin significantly improved blood glucose,body weight,and TG levels in patients with Metformin poorly controlled T2DM without significantly increasing adverse reactions.