利格列汀联合甘精胰岛素治疗老年2型糖尿病合并高血压的疗效与安全性

Effects of Linagliptin Combine with Insulin Glargine in Elderly Patients with Type 2 Diabetes Mellitus and Hypertension

目的:分析利格列汀联合基础胰岛素(甘精胰岛素)治疗老年2型糖尿病合并高血压的临床疗效与安全性。方法:采用随机分组的方法,将上饶卫生学校附属医院2019年5月至2020年5月收治的50例年龄≥65岁的2型糖尿病患者分为试验组和对照组,在常规口服降糖药和降压药基础上,试验组给予利格列汀+甘精胰岛素治疗,对照组予以甘精胰岛素治疗,比较治疗3个月后两组疗效和不良反应。结果:随访期间试验组无患者失访、对照组3例失访。治疗3个月后,与对照组相比,试验组空腹血糖(FBG)[(-1.7±0.8)mmol/L vs(-1.2±0.6)mmol/L,P<0.01],糖化血红蛋白(HbA1c)[(-2.1%±0.8%)vs(-1.4%±0.8%),P<0.01]降幅显著更大,而空腹胰岛素(FINS)升幅显著更大[(2.8±1.2)mU/L vs(1.9±1.4)mU/L,P<0.05]。两组患者胰岛素抵抗指数(HOMA-IR),体质量指数(BMI),血压指标[收缩压(SBP)、舒张压(DBP)]和血脂指标[低密度脂蛋白胆固醇(LDL)、甘油三酯(TG)和总胆固醇(TC)]治疗前后变化幅度差异无统计学意义(P>0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论:利格列汀联合甘精胰岛素可显著降低老年2型糖尿病合并高血压患者血糖且安全耐受,对患者胰岛素抵抗、体重、血压、血脂等无额外影响。

Objective:To assess the clinical efficacy and safety of linagliptin combined with basal insulin(insulin glargine)in the treatment of elderly type 2 diabetes patients with hypertension.Methods:50 patients with type 2 diabetes aged≥65 years who were admitted to the Affiliated Hospital of Shangrao Health School from May 2019 to May 2020 were randomly divided into the experimental group and the control group.Based on routine oral antidiabetic and antihypertensive treatments,patients treated with insulin glargine were regarded as control group,and patients in treatment group received linagliptin plus insulin glargine as the experimental group.The efficacy and adverse reactions of the two groups were compared after 3 months of treatment.Results:During the follow-up,three patients withdrew in the control group and no patients withdrew in the experimental group.After 3 months of treatment,the reductions in FBG[(-1.7±0.8)vs(-1.2±0.6)mmol/L,P<0.01],HbA1c[(-2.1%±0.8%)vs(-1.4%±0.8%),P<0.01]and the increase in FINS[(2.8±1.2)vs(1.9±1.4 mU/L),P<0.05]were significantly greater in the treatment group than in the control group.There was no significant difference between the two groups in changes of HOMA-IR,BMI,blood pressure indicators(SBP and DBP)and blood lipid indicators(LDL-C,TG and TC)after treatment(P>0.05).There was no significant difference in the incidence of all types of adverse reactions between the two groups(P>0.05).Conclusion:The combination of linagliptin combine with insulin glargine can significantly reduce the blood sugar of elderly type 2 diabetes patients with hypertension,and has no additional impact on insulin resistance,weight,blood pressure,blood lipids,etc.