甘精胰岛素结合那格列奈治疗老年2型糖尿病患者的临床疗效研究

Study on the Clinical Efficacy of Insulin Glargine Combined with Nateglinide in the Treatment of Elderly Patients with Type 2 Diabetes

目的 分析老年2型糖尿病实施甘精胰岛素+那格列奈治疗的效果。方法 选取2022年11月—2023年11月临沂东山医院收治的98例老年2型糖尿病患者为研究对象,以奇偶数法分为单药组和结合组,各49例。单药组行那格列奈治疗,结合组在单药组的治疗方案基础上增加甘精胰岛素治疗,比较两组临床疗效、血糖指标、胰岛素功能指标、不良反应发生情况。结果 结合组治疗有效率(97.96%)高于单药组(83.67%),差异有统计学意义(χ^(2)=5.995,P<0.05)。治疗前,两组空腹血糖、餐后2 h血糖、糖化血红蛋白指标水平比较,差异无统计学意义(P均>0.05);治疗后,两组空腹血糖、餐后2 h血糖、糖化血红蛋白水平均降低,且结合组低于单药组,差异有统计学意义(P均<0.05)。治疗前,两组胰岛素功能指标水平比较,差异无统计学意义(P>0.05);治疗后,两组胰岛素抵抗指数均降低,且结合组低于单药组,胰岛素分泌指数均升高,且结合组高于单药组,差异有统计学意义(P均<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 甘精胰岛素+那格列奈效果好,能控制血糖,改善胰岛素功能,且不良反应少,可改善老年2型糖尿病预后。

Objective To analyze the effect of insulin glargine+nateglinide in the treatment of type 2 diabetes in the elderly.Methods A total of 98 elderly patients with type 2 diabetes admitted to Linyi Dongshan Hospital from Novem-ber 2022 to November 2023 were selected as the research objects.They were divided into single drug group and com-bination group according to odd and even number method,with 49 cases in each group.The single drug group was treated with nateglinide,and the combined group was treated with insulin glargine on the basis of the treatment plan of the single drug group.The clinical efficacy,blood glucose indexes,insulin function indexes,and adverse reactions were compared between the two groups.Results The effective rate of the combined group(97.96%)was higher than that of the single drug group(83.67%),and the difference was statistically significant(χ^(2)=5.995,P<0.05).Before treat-ment,there were no statistically significant differences in the levels of fasting blood glucose,2-hour postprandial blood glucose and glycosylated hemoglobin between the two groups(all P>0.05).After treatment,the levels of fasting blood glucose,2-hour postprandial blood glucose and glycosylated hemoglobin in the two groups were decreased,and those in the combined group were lower than those in the single drug group,and the differences were statistically sig-nificant(P<0.05).Before treatment,there were no statistically significant differences in the levels of insulin function indexes between the two groups(all P>0.05).After treatment,the insulin resistance index of the two groups decreased,and the insulin secretion index of the combined group was lower than that of the single drug group,and the insulin se-cretion index of the combined group was higher than that of the single drug group,and the differences were statisti-cally significant(all P<0.05).There was no statistically significant difference in the incidence of adverse reactions be-tween the two groups(P>0.05).Conclusion Insulin glargine+nateglinide is effective,can control blood sugar,im-prove insulin function,has few adverse reactions,and can improve the prognosis of type 2 diabetes in the elderly.