利格列汀联合胰岛素治疗老年2型糖尿病肾病临床观察

Clinical observation of liagliptin and insulin treatment in elderly patients with type 2 diabetic nephropathy

目的:观察利格列汀联合胰岛素治疗老年2型糖尿病肾病患者的疗效。方法:选取中山大学附属第三医院内分泌科与代谢病学科老年2型糖尿病肾病患者60例,按随机数字表法分对照组与观察组,各30例。对照组采用门冬胰岛素30治疗,观察组采用利格列汀联合门冬胰岛素30治疗,共3个月。观察两组血糖指标、肾功能指标、胰岛素用量及低血糖发生情况。结果:治疗前,两组血糖指标、肾功能指标比较,差异无统计学意义(P>0.05);治疗后,观察组空腹血糖(FPG)、餐后2 h血糖(2 h PG)低于对照组,差异有统计学意义(P<0.05);治疗后,两组血肌酐(CR)、胱抑素C(CysC)、24 h尿微量蛋白(M-Alb)比较,差异无统计学意义(P>0.05);观察组胰岛素用量及血糖发生率低于对照组,差异有统计学意义(P<0.05)。结论:利格列汀联合胰岛素治疗老年2型糖尿病肾病,可有效控制血糖水平,保护肾功能,减少胰岛素用量,安全性高。

Objective To observe the efficacy of ligliptin and insulin in elderly patients with type 2 diabetic nephropathy.Method 60 elderly patients with type 2 diabetic nephropathy were selected,and they were divided into control group and observation group according to random numbers.30 cases in each group.The control group was treated with gendon insulin 30,and the observation group was treated with liagliptin combined with gendon insulin 30 for a total of 3 months.Blood glucose index,renal function index,insulin consumption and hypoglycemia in the two groups were observed.Results Before treatment,there was no statistically significant difference between blood glucose and renal function indexes of the two groups(P>0.05);After treatment,fasting blood glucose(FPG),postprandial blood glucose(2 h P G) were lower than the control group(P<0.05);After treatment,there was no statistically significant difference in blood creatinine(CR),Cystatin C(CysC) and 24-h urinary microprotein(M-Alb) between the two groups(P>0.05),the amount of insulin and the incidence of blood glucose in the observation group were lower than those in the control group,the difference was statistically significant(P<0.05).Conclusion Conclusion Ligagliptin and insulin for elderly type 2 diabetic nephropathy can effectively control blood glucose level,protect renal function,reduce insulin dosage and have high safety.