磷酸西格列汀对T2DM患者糖代谢及胰岛素抵抗的治疗效果

Therapeutic effect of sitagliptin phosphate on glucose metabolism and insulin resistance in patients with type 2 diabetes mellitus

目的分析磷酸西格列汀对治疗2型糖尿病(T2DM)患者的糖代谢和胰岛素抵抗的效果。方法选择2021年1月至2022年1月收治的T2DM患者90例,数字随机抽签分为对照组和观察组,每组45例。对照组给予常规药物治疗,观察组在对照组基础上加用磷酸西格列汀,分析2组的胰岛素功能、空腹血糖、2 h血糖、糖化血红蛋白的水平及不良反应情况。结果治疗前2组胰岛素水平差异无统计学意义(P>0.05)。治疗后,与对照组相比,观察组的胰岛素功能指标(包括HOMA-IS2 h PINS、HOMA-β、FINS)改善效果更优(P<0.05)。治疗前,2组血糖水平差异无统计学意义(P>0.05);治疗后,观察组血糖水平(包括HbA1c、FBG、2hPBG)均低于对照组(P<0.05)。观察组TNF-α、CRP、IL-6水平较治疗前下降(P<0.05),与对照组比较,差异显著(P<0.05);IL-10水平较治疗前升高,与对照组比较差异显著(P<0.05)。观察组总不良反应发生率为4.44%,低于对照组的17.77%,差异有统计学意义(P<0.05)。结论磷酸西格列汀应用T2DM治疗中,能降低患者的胰岛素抵抗和血糖水平,调节患者炎性因子,效果更优,值得推荐。

Objective To analyze the effect of sitagliptin phosphate on glucose metabolism and insulin resistance in patients with type 2 diabetes mellitus(T2DM).Methods From January 2021 to January 2022,totally 90 T2DM patients admitted in the hospital were enrolled and randomly divided into control group and observation group,with 45 cases in each group.All patients were managed by conventional drug treatment,and those in the observation group additionally received sitagliptin phosphate.The aim was to compare insulin function,fasting blood glucose(FBG),2h postprandial blood glucose(2hPBG),glycosylated hemoglobin(HbA1c)levels and adverse reactions of the two groups.Results The difference was not statistically significant in insulin levels between the two groups before treatment(P>0.05).After treatment,the improvement of insulin function indexes including homeostatic model assessment of insulin sensitivity(HOMA-IS),2-hour postprandial insulin(2h PINS),homeostasis model assessment-beta(HOMA-β),and fasting serum insulin(FINS)in the observation group was significantly better than that in the control group(P<0.05).There was no significance in the comparison between groups before treatment(P>0.05).After treatment,HbA1c,FBG and 2hPBG in the observation group were significantly lower than those in the control group(P<0.05).Significantly decreased tumor necrosis factor-alpha(TNF-α),C-reactive protein(CRP),interleukin-6(IL-6),and increased IL-10 were detected in the observation group after treatment(all P<0.05),and the different was significant between the observation group and control group for the above indexes(all P<0.05).The total incidence of adverse reactions in the observation group was significantly lower than that of the control group(4.44%vs 17.77%,P<0.05).Conclusion For T2DM patients,sitagliptin phosphate is beneficial to reduce insulin resistance and blood glucose levels,and regulate inflammatory factors,which is worthy of clinical recommendation.