SGLT-2抑制剂对2型糖尿病患者血糖波动的影响

Effects of taking SGLT-2 inhibitors on glucose fluctuations in patients with type 2 diabetes

目的 :探讨SGLT-2抑制剂对于2型糖尿病患者血糖波动的影响。方法 :选取2020年1月~2022年1月在湖南省某三级医院内分泌科治疗的116例2型糖尿病患者,随机分为观察组和对照组各58例,两组患者均予以二甲双胍和胰岛素降糖。在此基础上观察组使用SGLT-2抑制剂的代表药物达格列净,对照组使用西格列汀,各治疗12周。对两组患者接受治疗前后的血糖波动相关指标变化情况进行比较。结果 :治疗后两组患者空腹血糖(FBG)、餐后2小时血糖(2h PG)、糖化血红蛋白(Hb A1c)、血糖变异系数(CV)、平均血糖、血糖水平标准差(SDBG)、餐后血糖的波动幅度(PPGE)、最大血糖波动幅度(LAGE)均低于治疗前,葡萄糖的目标范围内时间(TIR)高于治疗前;且治疗后观察组CV、平均血糖、SDBG、PPGE、LAGE、TIR与对照组比较,差异具有统计学意义;观察组患者△平均血糖、△SDBG、△PPGE、△LAGE、△CV、△TIR等指标明显大于对照组。结论 :使用SGLT-2抑制剂可有效控制血糖波动。

Objective This study is mainly to observe the role of SGLT-2 inhibitor on glucose fluctuations in type 2 diabetes. Methods 116 patients with type 2 diabetes treated or hospitalized in the endocrinology department of a tertiary hospital in Hunan Province from January 2020 to January 2022 were divided randomly into the observation group(n=58) and the control group(n=58). In both groups, patients were all treated with Metformin and insulin. On this basis, the observation group was treated with Dapagliflozin, a representative drug of SGLT-2 inhibitor, and the control group was treated with Sitagliptin. Both groups received 12 weeks of treatment. Comparison was made on the changes of glucose fluctuation related indexes before and after treatment. Results The comparison between the two groups after and before treatment, FBG, 2h PG and HbA1c in the two groups decreased. The blood glucose coefficient of variation(CV), mean blood glucose, the standard deviation of blood glucose(SDBG), the postprandial glucose excursion(PPGE) and the largest amplitude of glycemic excursions(LAGE) were lower than those before treatment, while the time in range(TIR) was extended. After treatment: mean blood glucose, SDBG, LAGE, PPGE, CV of the observation group decreased significantly, and the TIR value increased significantly. The results also showed that the differences of mean blood glucose, SDBG, PPGE, LAGE, CV and TIR in the group of observers before and after treatment were significantly increased more than those in the control group. Conclusion The use of SGLT-2 inhibitors can effectively control the fluctuation of glucose.