卡格列净联合门冬胰岛素治疗血糖控制不佳老年2型糖尿病的临床研究

Clinical study of kangkagliflozin combined with insulin aspart in the treatment of elderly type 2 diabetes mellitus with poor blood glucose control

目的:探讨卡格列净联合胰岛素治疗血糖控制不佳2型糖尿病(T2DM)老年患者的疗效及安全性。方法:选取116例T2DM老年患者为研究对象,按照治疗方案不同将患者分为对照组与治疗组,每组各58例。对照组予以胰岛素治疗;治疗组在胰岛素治疗基础上予以卡格列净片口服治疗,连续治疗两周。比较两组疗效、血糖、胰岛β细胞功能[胰岛素β细胞抵抗指数(HOMA-IR)、胰岛素β细胞分泌功能指数(HOMA-β)]和炎症因子[超敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)]水平及不良反应发生率。结果:治疗组总有效率为93.10%,高于对照组的79.31%(P<0.05)。治疗后,两组患者空腹血糖、餐后2 h血糖(2hPG)、糖化血红蛋白均降低(P<0.05),且治疗组均低于对照组(P<0.05);两组患者HOMA-IR均降低(P<0.05),HOMA-β均增高(P<0.05),且治疗组HOMA-IR低于对照组(P<0.05),HOMA-β高于对照组(P<0.05);两组患者hs-CRP和IL-6水平均降低(P<0.05),且治疗组低于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:卡格列净联合胰岛素治疗血糖控制不佳T2DM老年患者能够更有效控制血糖水平,改善胰岛β细胞功能,减轻炎症反应。

Objective:To investigate the efficacy and safety of canagliflozin combined with insulin in the treatment of elderly patients with type 2 diabetes mellitus(T2DM)with poor glycemic control.Methods:A total of 116 elderly patients with T2DM were divided into control group and treatment group according to the different treatment plans,with 58 cases in each group.The control group was treated with insulin,and the treatment group was treated with oral canagliflozin tablets on the basis of insulin therapy for 2 weeks.The efficacy,blood glucose,blood lipid,isletβcell function[insulinβcell resistance index(HOMA-IR),insulinβcell secretion function index(HOMA-β)]and inflammatory factors[high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6)],and adverse reactions were compared between the two groups.Results:The total effective rate was 93.10%in the treatment group,which was higher than 79.31%in the control group(P<0.05).After treatment,the fasting blood glucose,2 h postprandial blood glucose and glycosylated hemoglobin in the two groups were lower than those before treatment(P<0.05),and the treatment group was lower than the control group(P<0.05).HOMA-IR decreased and HOMA-βincreased in the two groups(P<0.05),and HOMA-IR in the treatment group was lower than that in the control group(P<0.05),HOMA-βin the treatment group was higher than that in the control group(P<0.05).The serum levels of hs-CRP and IL-6 decreased in both groups,and the treatment group was lower than the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Canagliflozin combined with insulin in the treatment of elderly patients with T2DM with poor glycemic control can more effectively control blood glucose levels,improve isletβcell function,and reduce inflammatory response.