二甲双胍治疗社区老年2型糖尿病患者的疗效及安全性分析

Efficacy and Safety Analysis of Metformin in the Treatment of Elderly Type 2 Diabetes Patients in Community

目的 研究二甲双胍治疗社区老年2型糖尿病患者的疗效及安全性。方法 选取2017年9月-2022年9月盐湖区人民医院及惠城区桥西街道办事处社区卫生服务中心收治的66例老年2型糖尿病患者为研究对象,按随机数表法分为对照组(n=33,接受阿卡波糖治疗)和研究组(n=33,接受二甲双胍治疗)。比较两组治疗前后血糖指标水平、空腹胰岛素、胰岛素敏感指数及胰岛素抵抗指数、临床疗效及并发症发生率。结果 治疗前,两组血糖指标水平对比,差异无统计学意义(P>0.05);治疗后,研究组糖化血红蛋白(glycosylated hemoglobin, HbA1c)、空腹血糖(fasting plasma glucose, FPG)、餐后2 h血糖(2-hour postprandial blood glucose, 2 hPG)水平均低于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者胰岛素指标水平对比,差异无统计学意义(P>0.05);治疗后研究组空腹胰岛素(fasting insulin, FINS)、胰岛素抵抗指数(homeostasis model assessment for insulin resistance, HOMA-IR)水平均低于对照组,胰岛素敏感指数(insulin sensitivity index, ISI)水平高于对照组,差异有统计学意义(P<0.05)。研究组治疗总有效率为96.97%高于对照组的75.76%,差异有统计学意义(P<0.05)。研究组并发症发生率为6.06%,低于对照组的27.27%,差异有统计学意义(P<0.05)。结论 二甲双胍可显著降低社区老年2型糖尿病患者血糖指标水平及不良反应发生率,改善胰岛素指标水平,提高疗效,保障安全性。

Objective To investigate the efficacy and safety of metformin in the treatment of elderly type 2 diabetes patients in community.Methods 66 elderly patients with type 2 diabetes admitted to Yanhu District People's Hospital and Community Health Service Center of Qiaoxi Street Office of Huicheng District from September 2017 to September 2022 were selected as the study subjects and divided into control group(n=33,received acarbose treatment)and study group(n=33,received metformin treatment)according to random number table method.The blood glucose level,fast-ing insulin,insulin sensitivity index and insulin resistance index,clinical efficacy and incidence of adverse reactions were compared before and after treatment.Results Before treatment,there was no difference statistically significant in blood glucose level between the two groups(P>0.05).After treatment,the levels of glycosylated hemoglobin(HbA1c),fasting plasma glucose(FPG)and 2 h postprandial blood glucose(2 hPG)in the study group were lower than those in the control group,the difference was statistically significant(P<0.05).Before treatment,there was no difference statis-tically significant in the level of insulin indexes between the two groups(P>0.05).After treatment,fasting insulin(FINS)and homeostasis model assessment for insulin resistance(HOMA-IR)levels in the study group were lower than those in the control group,and insulin sensitivity index(ISI)levels were higher than those in the control group,the dif-ference was statistically significant(P<0.05).The total effective rate of the study group was 96.97%higher than that of the control group 75.76%,the difference was statistically significant(P<0.05).The complication rate of 6.06%in the study group was lower than 27.27%in the control group,the difference was statistically significant(P<0.05).Conclusion Metformin can significantly reduce the level of blood glucose index and the incidence of adverse reactions in elderly patients with type 2 diabetes in the community,improve the level of insulin index,improve the efficacy and ensure safety.