达格列净与西格列汀分别联合二甲双胍治疗肥胖2型糖尿病的临床效果

Clinical Effect of Dapagliflozin and Sitagliptin Combined with Metformin in Treatment of Obesity and Type 2 Diabetes Mellitus

目的:探讨达格列净与西格列汀分别联合二甲双胍治疗肥胖2型糖尿病(T2DM)的效果。方法:选取2021年1月—2023年1月珠海市香洲区第二人民医院收治的肥胖T2DM患者84例为研究对象,根据随机数字表法分为试验1组、试验2组,各42例。试验1组采用达格列净联合二甲双胍治疗,试验2组采用西格列汀联合二甲双胍治疗。比较两组血糖水平、胰岛功能、体质量、腰围、不良反应。结果:治疗后,两组空腹血糖、糖化血红蛋白、餐后2 h血糖、空腹胰岛素、胰岛素抵抗指数均降低,胰岛β细胞功能指数均升高,试验1组优于试验2组,差异有统计学意义(P<0.05);治疗后,两组体质量、腰围均下降,差异有统计学意义(P<0.05);试验1组不良反应发生率高于试验2组,差异有统计学意义(P=0.026)。结论:达格列净联合二甲双胍治疗肥胖T2DM患者的血糖控制及胰岛素抵抗改善效果优于西格列汀联合二甲双胍,但不良反应发生率较西格列汀联合二甲双胍高,临床需要根据患者情况选择适合的治疗方案。

Objective:To explore the effect of Dapagliflozin and Sitagliptin combined with Metformin in the treatment of obesity and type 2 diabetes mellitus(T2DM).Methods:A total of 84 patients with obesity and T2DM admitted to the Second People's Hospital of Xiangzhou District of Zhuhai City from January 2021 to January 2023 were selected as the study subjects.According to the random number table method,they were divided into experimental 1 group and experimental 2 group,with 42 cases in each group.The experimental 1 group was treated with Dapagliflozin combined with Metformin,and the experimental 2 group was treated with Sitagliptin combined with Metformin.The treatment effects of the two groups were compared.Results:After treatment,fasting blood glucose,glycosylated hemoglobin,2 h postprandial blood glucose,fasting insulin and insulin resistance index were decreased,while pancreaticβcell function index were increased in the two groups,the experimental 1 group was better than the experimental 2 group,and the difference was statistically significant(P<0.05);after treatment,the body weight and waist circumference in the two groups were decreased,and the difference was statistically significant(P<0.05);the total incidence of adverse reactions in the experimental 1 group was higher than that in the experimental 2 group,and the difference was statistically significant(P=0.026).Conclusion:Dapagliflozin combined with Metformin is better than Sitagliptin on blood glucose control and insulin resistance improvement in the treatment of obesity and T2DM patients,but the incidence of adverse reactions is higher than that of Sitagliptin.It is necessary to select appropriate treatment plan according to the patient's situation.