达格列净联合预混胰岛素治疗血糖控制较差的2型糖尿病患者的临床疗效及安全性

Clinical Efficacy and Safety of Dagliflozin Combined with Premixed Insulin in the Treatment of Patients with Type 2 Diabetes Mellitus with Poor Glycemic Control

目的:探讨达格列净对注射门冬胰岛素治疗血糖控制不达标的2型糖尿病患者的临床价值。方法:选取2020年1月—2021年6月贵州省六盘水市盘州市盘江煤电有限公司总医院收治的96例注射门冬胰岛素治疗血糖控制不达标的2型糖尿病患者作为研究对象,按照治疗方法分成对照组和研究组,每组各48例。治疗期间监测血糖,根据血糖水平调整胰岛素剂量,比较两组患者空腹血糖(FBG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)、血糖达标时间、日均胰岛素用量以及治疗前后的体质量变化,并统计两组患者各类副反应的出现人数占比,包括低血糖、腹泻、恶心呕吐等情况。结果:治疗3个月后,研究组HbA1c、FBG及2 hPG均低于对照组,差异有统计学意义(t=6.448、13.448、7.228,P<0.05)。两组患者治疗后体质量较治疗前明显下降,但研究组体重稍高于对照组,且研究组日均胰岛素用量少于对照组,血糖指标达标时间短于对照组,差异有统计学意义(t=8.080、14.417、19.031,P<0.05)。两组患者胃肠道反应发生率比较,差异无统计学意义(P>0.05)。研究组低血糖发生率(2.08%)明显低于对照组(12.50%),差异有统计学意义(t=38.170,P<0.05)。结论:达格列净治疗2型糖尿病疗效确切,能改善患者的血糖指标,减少副反应出现。

Objective:To investigate the clinical value of dagliflozin in the treatment of type 2 diabetes mellitus with substan⁃dard glycemic control by injectable menthol insulin.Methods:96 patients with type 2 diabetes mellitus who were admitted to the hospital from January 2020 to June 2021 with substandard glycemic control treated with injectable mentored insulin were selected and divided into a control group and a study group according to the treatment method,with 48 cases in each group.The blood glu⁃cose was monitored during treatment and the insulin dose was adjusted according to the blood glucose level.The fasting blood glu⁃cose(FBG),2-h postprandial blood glucose(2 hPG),glycosylated hemoglobin(HbA1c),time to blood glucose standard,average dai⁃ly insulin dosage,and changes in body mass before and after treatment were compared between the two groups.The percentage of the occurrence of various types of side effects,including hypoglycemia,diarrhea,nausea and vomiting,was counted in both groups.Results:After 3 months of treatment,HbA1c,FBG and 2 hPG were lower in the study group than in the control group,and the dif⁃ferences were statistically significant(t=6.448,13.448,7.228,P<0.05).The body mass of both groups decreased significantly after treatment compared with that before treatment,but the body weight of the study group was slightly higher than that of the control group,and the average daily insulin dosage of the study group was less than that of the control group,and the time to achieve the blood glucose index was shorter than that of the control group,with statistically significant differences(t=8.080,14.417,19.031,P<0.05).There was no statistically significant difference in the incidence of gastrointestinal reactions between the two groups(P>0.05).The incidence of hypoglycemia in the study group(2.08%)was significantly lower than that in the control group(12.50%),and the difference was statistically significant(t=38.170,P<0.05).Conclusion:Dagliflozin is effective in treating type 2 diabetes,improving patients’blood glucose index and reducing the occurrence of side effects.