达格列净联合瑞格列奈与甘精胰岛素治疗2型糖尿病的临床效果

Clinical Effect of Dapagliflozin Combined with Repaglinide and Insulin Glargine in the Treatment of Type 2 Diabetes Mellitus

目的分析达格列净结合瑞格列奈与甘精胰岛素治疗2型糖尿病(type 2 diabetes mellitus,T2DM)的临床效果。方法选取2022年2月—2023年7月临沂市兰山区人民医院收治的80例T2DM患者为研究对象,按治疗方法不同分为对照组和观察组,各40例。对照组采用瑞格列奈+甘精胰岛素治疗,观察组在对照组基础上联合达格列净治疗。比较两组疗效、临床指标水平(空腹血糖、餐后2 h血糖、糖化血红蛋白、胰岛素抵抗指数、胰岛β细胞功能指数)、不良反应(头晕、恶心、低血糖)发生情况。结果观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗前,两组空腹血糖、餐后2 h血糖、糖化血红蛋白水平、胰岛素抵抗指数、胰岛β细胞功能指数比较,差异无统计学意义(P均>0.05);治疗后,观察组空腹血糖、餐后2 h血糖、糖化血红蛋白水平、胰岛素抵抗指数均低于对照组,胰岛β细胞功能指数高于对照组,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)。结论达格列净+瑞格列奈+甘精胰岛素治疗T2DM疗效显著,且对患者血糖及胰岛素功能均有积极改善,临床用药安全。

Objective To analyze the clinical effect of dapagliflozin combined with repaglinide and insulin glargine in the treatment of type 2 diabetes mellitus(T2DM).Methods A total of 80 patients with T2DM admitted to Lanshan Dis-trict People's Hospital of Linyi from February 2022 to July 2023 were selected as the research objects.According to different treatment methods,they were divided into the control group and the observation group,with 40 cases in each group.The control group was treated with repaglinide+insulin glargine,and the observation group was treated with dapagliflozin on the basis of the control group.The efficacy,clinical index levels fasting plasma glucose,2-hour post-prandial plasma glucose,glycated hemoglobin A1c,homeostatic model assessment of insulin resistance,homeostasis model assessment-βand the accurrence of adverse reactions(dizziness,nausea,hypoglycemia)were compared be-tween the two groups.Results The total effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).Before treatment,there were no statistically significant differences in fasting plasma glucose,2-hour postprandial plasma glucose,glycated hemoglobin A1c levels,homeo-static model assessment of insulin resistance,and homeostasis model assessment-βbetween the two groups(all P>0.05).After treatment,the fasting plasma glucose,2-hour postprandial plasma glucose,glycated hemoglobin A1c and homeostatic model assessment of insulin resistance in the observation group were lower than those in the control group,and the homeostasis model assessment-βwas higher than that in the control group,and the differences were statistically significant(all P<0.05).There was no statistically significant difference in the incidence of adverse reac-tions between the two groups(P>0.05).Conclusion The curative effect of dapagliflozin+repaglinide+insulin glargine in the treatment of T2DM is significant,and the blood glucose and insulin function of the patients are positively im-proved,and the clinical medication is safe.