达格列净对预混胰岛素治疗血糖控制不达标的2型糖尿病患者的疗效观察

Efficacy observation of dapagliflozin in patients with type 2 diabetes mellitus who failed to achieve glycemic control treated with premixed insulin

目的 通过达格列净对预混胰岛素治疗血糖控制不达标的2型糖尿病患者进行治疗,评估其治疗效果。方法 50例使用门冬胰岛素30控制血糖不达标的2型糖尿病患者,随机分为观察组和对照组,各25例。对照组给予二甲双胍和阿卡波糖治疗,观察组在对照组的基础上给予达格列净治疗。比较两组患者治疗后的空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbA1c)、胰岛素剂量、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)水平。结果 观察组患者FBG(6.5±2.4)mmol/L、2 h PBG(10.2±3.4)mmol/L、HbA1c(7.2±0.9)%、胰岛素剂量(34.9±5.9)U/d均低于对照组的(8.3±3.1)mmol/L、(13.7±4.7)mmol/L、(8.5±1.0)%、(44.8±6.5)U/d,差异均具有统计学意义(P<0.05)。观察组患者TC(4.2±1.5)mmol/L、TG(1.7±0.4)mmol/L、LDL-C(2.8±0.9)mmol/L均低于对照组的(5.2±1.3)、(2.1±0.5)、(3.5±1.0)mmol/L,HDL-C(1.4±0.3)mmol/L高于对照组的(1.1±0.2)mmol/L,差异均具有统计学意义(P<0.05)。结论 达格列净对预混胰岛素治疗血糖控制不达标的2型糖尿病患者,可有效降低血糖水平,显著改善患者的血脂指标,值得临床推广应用。

Objective To evaluate the effect of dapagliflozin on patients with type 2 diabetes mellitus who failed to achieve glycemic control treated with premixed insulin.Methods A total of 50 patients with type 2 diabetes mellitus who failed to achieve glycemic control treated with insulin aspart 30 were randomly divided into observation group and control group,with 25 cases in each group.The control group was treated with metformin and acarbose,and the observation group was treated with dapagliflozin on the basis of the control group.Both groups were compared in terms of fasting blood glucose(FBG),2 h postprandial blood glucose(2 h PBG),glycosylated hemoglobin(HbA1c),insulin dose,total cholesterol(TC),triglyceride(TG),low-density lipoproteincholesterol(LDL-C),high-density lipoprotein-cholesterol(HDL-C)levels after treatment.Results The FBG(6.5±2.4)mmol/L,2 h PBG(10.2±3.4)mmol/L,HbA1c(7.2±0.9)%and insulin dose(34.9±5.9)U/d in the observation group were lower than(8.3±3.1)mmol/L,(13.7±4.7)mmol/L,(8.5±1.0)%and(44.8±6.5)U/d in the control group,and the differences were all statistically significant(P<0.05).The TC(4.2±1.5)mmol/L,TG(1.7±0.4)mmol/L,LDL-C(2.8±0.9)mmol/L in the observation group were lower than(5.2±1.3),(2.1±0.5),(3.5±1.0)in the control group,and HDL-C(1.4±0.3)mmol/L was higher than(1.1±0.2)mmol/L in the control group,and the differences were all statistically significant(P<0.05).Conclusion For patients with type 2 diabetes mellitus who failed to achieve glycemic control treated with premixed insulin,dapagliflozin can reduce blood glucose level and significantly improve the blood lipid indicators of patients,which is worthy of clinical promotion and application.