西格列汀联合二甲双胍治疗老年2型糖尿病患者的效果

Effects of Sitagliptin combined with Metformin in treatment of elderly patients with type 2 diabetes mellitus

目的:观察西格列汀联合二甲双胍治疗老年2型糖尿病(T2DM)患者的效果。方法:选取2022年1月至2024年1月该院收治的96例老年T2DM患者进行前瞻性研究,按照随机数字表法将其分为研究组与对照组各48例。对照组采用二甲双胍治疗,研究组在对照组基础上联合西格列汀治疗,比较治疗前后糖代谢指标[空腹血糖(FPG)、餐后2 h血糖(2hPG)、胰高血糖素样肽-1(GLP-1)]、脂代谢指标[总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、三酰甘油(TG)]、胰岛功能指标[空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)]、炎性因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)]水平,以及不良反应发生率。结果:治疗后,两组FPG、2hPG水平均低于治疗前,且研究组低于对照组,两组GLP-1水平均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05);两组TG、TC、LDL-C水平均低于治疗前,且研究组低于对照组,两组HDL-C水平均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05);两组FINS水平均高于治疗前,且研究组高于对照组,两组HOMA-IR水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组CRP、IL-6水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<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:西格列汀联合二甲双胍治疗老年T2DM患者可改善脂代谢指标和胰岛功能指标水平,降低糖代谢指标和炎性因子水平,其效果优于单纯二甲双胍治疗。

Objective:To observe effects of Sitagliptin combined with Metformin in treatment of elderly patients with type 2 diabetes mellitus(T2DM).Methods:A prospective study was conducted on 96 elderly patients with T2DM admitted to the hospital from January 2022 to January 2024.According to the random number table method,they were divided into study group and control group,48 cases in each group.The control group was treated with Metformin,while the study group was treated with Sitagliptin on the basis of that of the control group.The levels of glucose metabolism indexes[fasting blood glucose(FPG),2 h postprandial blood glucose(2hPG),glucagon-like peptide-1(GLP-1)],lipid metabolism indexes[total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),triacylglycerol(TG)],islet function indexes[fasting insulin(FINS),insulin resistance index(HOMA-IR)]and inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6)]before and after the treatment,and the incidence of adverse reactions were compared.Results:After the treatment,the levels of FPG and 2hPG in the two groups were lower than those before the treatment,those in the study group were lower than those in the control group,the levels of GLP-1 in the two groups were higher than those before the treatment,those in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of TG,TC and LDL-C in the two groups were lower than those before the treatment,and those in the study group were lower than those in the control group;the levels of HDL-C in the two groups were higher than those before the treatment,and that in the study group was higher than that in the control group;and the differences were statistically significant(P<0.05).After the treatment,the FINS levels of the two groups were higher than those before the treatment,and that in the study group was higher than that in the control group;the HOMA-IR levels of the two groups were lower than those before the treatment,and that in the study group was lower than that in the control group;and the differences were statistically significant(P<0.05).After the treatment,the levels of CRP and IL-6 in the two groups were lower than those before the treatment,those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Sitagliptin combined with Metformin in the treatment of the elderly patients with T2DM can improve the levels of lipid metabolism indexes and islet function indexes,and reduce the levels of glucose metabolism indexes and inflammatory factors.Moreover,it is superior to simple Metformin treatment.