卡格列净联合胰岛素治疗肥胖2型糖尿病的效果及对胰岛素抵抗、脂质代谢的影响

Effect of canagliflozin combined with insulin in the treatment of obese type 2 diabetes mellitus and its influences on insulin resistance and lipid metabolism

目的探讨卡格列净联合胰岛素治疗肥胖2型糖尿病(T2DM)的效果及对胰岛素抵抗、脂质代谢的影响。方法选取2019年1月至2021年10月收治的80例肥胖T2DM患者作为研究对象,按照随机数字表法将其分为对照组和观察组,各40例。两组均给予常规治疗,对照组在常规治疗基础上给予胰岛素治疗,观察组在对照组基础上给予卡格列净治疗。比较两组的治疗效果。结果治疗后,观察组的平均血糖波动幅度(MAGE)、日间血糖平均绝对差(MODD)、72 h血糖水平标准差(SDBG)、胰岛素抵抗指数(HOMA-IR)、总胆固醇(TC)、三酰甘油(TG)、载脂蛋白B(ApoB)、低密度脂蛋白胆固醇(LDL-C)水平、腰围(WC)、体质指数(BMI)、内脏脂肪面积(VFA)低于对照组,胰岛β细胞功能指数(HOMA-β)、胰岛素敏感指数(ISI)高于对照组(P<0.05)。结论卡格列净联合胰岛素治疗肥胖T2DM能提高血糖控制效果,减轻胰岛素抵抗,改善脂质代谢,值得推广。

Objective To explore the effect of canagliflozin combined with insulin in the treatment of obese type 2 diabetes mellitus(T2DM)and its influences on insulin resistance and lipid metabolism.Methods A total of 80 obese T2DM patients admitted from January 2019 to October 2021 were selected as the research objects and divided into control group and observation group according to the random number table method,with 40 cases in each group.Both groups were given routine treatment,the control group was treated with insulin on the basis of routine treatment,and the observation group was treated with canagliflozin on the basis of the control group.The therapeutic effects of the two groups were compared.Results After treatment,the mean amplitude of glycemic excursions(MAGE),mean of daily differences(MODD),72 h standard deviation of blood glucose(SDBG),homeostasis model assessment of insulin resistance(HOMA-IR),total cholesterol(TC),triacylglycerol(TG),apolipoprotein B(ApoB),low density lipoprotein cholesterol(LDL-C)levels,waist circumference(WC),body mass index(BMI)and visceral fat area(VFA)in the observation group were lower than those in the control group,while the homeostasis model assessment ofβcell function index(HOMA-β)and insulin sensitivity index(ISI)were higher than those of the control group(P<0.05).Conclusion Canagliflozin combined with insulin in the treatment of obese T2DM can promote the effect of blood glucose control,reduce insulin resistance and improve lipid metabolism,which is worthy of promotion.