瑞格列奈联合地特胰岛素对2型糖尿病伴肥胖患者治疗效果及氧化应激反应的影响

Therapeutic Effect of Repaglinide Combined with Insulin Detemir on Patients with Type 2 Diabetes Mellitus and Obesity and the Influence on Oxidative Stress Response

目的观察瑞格列奈联合地特胰岛素对2型糖尿病(T2MD)伴肥胖患者治疗效果及氧化应激反应的影响。方法选取本院2019年9月~2021年8月收治的T2MD伴肥胖患者共计100例,根据信封随机法将患者分为单一组与联合组,每组50例。单一组采用皮下注射地特胰岛素进行治疗,联合组采用瑞格列奈联合地特胰岛素进行治疗。比较两组患者药物治疗效果、治疗前后体质量指数(BMI)变化情况、氧化应激反应及不良事件发生率。结果给予药物治疗后,两组患者空腹血糖(FPG)及餐后两小时血糖(2hPG)、糖化血红蛋白(HbAlc)水平均比治疗前低,联合组患者FPG和2hPG水平、HbAlc变化相比于单一组更大(P<0.05);治疗后,两组患者日间血糖平均绝对差(MODD)及平均血糖波动幅度(MAGE)均降低,联合组相较于单一组降低显著(P<0.05);治疗后,两组患者BMI均降低,联合组患者相较于单一组治疗1个月、3个月后BMI更低(P<0.05);治疗后,联合组相较于单一组超氧化物歧化酶(SOD)及过氧化氢酶(CAT)水平更高,丙二醛(MDA)水平更低(P<0.05)。与单一组相比,联合组低血糖、恶心、皮下脂肪营养不良等不良事件发生率显著较低(P<0.05)。结论瑞格列奈联合地特胰岛素治疗T2MD伴肥胖患者效果明显,能有效调节患者血糖代谢,且有助于控制BMI,可有效减少氧化应激反应及不良事件发生。

Objective To observe the therapeutic effect of repaglinide combined with insulin detemir on patients with type 2 diabetes mellitus(T2MD)and obesity,and the influence on oxidative stress response.Methods A total of 100 patients with T2MD and obesity were admitted to the hospital from September 2019 to August 2021.The patients were divided into single group and combined group according to the envelope random method,with 50 cases in each group.Patients in the single group were treated with subcutaneous injection of insulin detemir,while patients in the combined group were treated with repaglinide combined with insulin detemir.Therapeutic effects,body mass index(BMI),oxidative stress response and the incidence of adverse events were compared between the two groups.Results After treatment,the levels of fasting plasma glucose(FPG),2-hour postprandial plasma glucose(2hPG)and glycosylated hemoglobin(HbAlc),mean of daily differences(MODD)and mean amplitude of glycemic excursion(MAGE)were decreased in the two groups.The decreases were greater in the combined group than in the single group(P<0.05).After treatment,the BMI was decreased in the two groups,and the BMI of combined group was lower than that of the single group after 1 month and 3 months of treatment(P<0.05).After treatment,the levels of superoxide dismutase(SOD)and catalase(CAT)were increased,and the level of malondialdehyde(MDA)was decreased(P<0.05).The incidence rates of adverse events such as hypoglycemia,nausea and subcutaneous lipodystrophy in the combined group were significantly lower than those in the control group(P<0.05).Conclusion Repaglinide combined with insulin detemir is effective in the treatment of patients with T2MD and obesity,which can effectively regulate blood glucose metabolism in the patients,help to control BMI,and effectively reduce oxidative stress and adverse events.