恩格列净联合二甲双胍治疗2型糖尿病的效果及对血糖变异性、胰岛素抵抗的影响研究

Study on the Effect of Empagliflozin Combined with Metformin in the Treatment of Type 2 Diabetes and Its Effect on Blood Glucose Variability and Insulin Resistance

目的研究采用恩格列净联合二甲双胍治疗2型糖尿病(diabetes mellitus type 2,T2DM)患者的临床价值。方法非随机选取2021年8月—2023年8月牡丹江医学院附属红旗医院收治的100例T2DM患者,按治疗方法不同分为两组,各50例。对照组给予二甲双胍治疗,联合组给予二甲双胍结合恩格列净治疗。比较两组患者治疗效果、血糖水平、血糖变异性、胰岛功能指标和不良反应。结果联合组治疗总有效率为98.00%(49/50),高于对照组的80.00%(40/50),差异有统计学意义(χ^(2)=8.274,P<0.05)。治疗后,联合组各项血糖水平指标均低于对照组;联合组各项血糖变异性指标均低于对照组,差异有统计学意义(P均<0.05)。联合组空腹胰岛素为(7.43±1.97)mIU/L,高于对照组的(5.88±1.85)mIU/L;联合组胰岛β细胞功能指数为46.03±8.96,高于对照组的38.58±6.74;联合组胰岛素抵抗指数为1.73±0.47,低于对照组的2.08±0.33,差异均有统计学意义(t=4.056、4.698、4.310,P均<0.05)。联合组不良反应低于对照组,差异无统计学意义(P>0.05)。结论采用恩格列净联合二甲双胍治T2DM患者高效安全,能调节血糖水平,增强血糖控制效果,还可改善胰岛功能,使胰岛素抵抗降低。

Objective To study the clinical value of empagliflozin combined with metformin in the treatment of patients with type 2 diabetes mellitus(T2DM).Methods A total of one hundred patients with T2DM admitted to Hongqi Hospital Affiliated to Mudanjiang Medical College from August 2021 to August 2023 were non-randomly selected and divided into two groups according to different treatment methods,with fifty cases in each group.The control group was treated with metformin,and the combined group was treated with metformin combined with empagliflozin.The therapeutic effect,blood glucose level,blood glucose variability,islet function index and adverse reactions were compared between the two groups.Results The total effective rate of treatment in the combined group was 98.00%(49/50),which was higher than 80.00%(40/50)in the control group,and the difference was statistically significant(χ^(2)=8.274,P<0.05).After treatment,the blood glucose levels of the combined group were lower than those of the control group;the blood glucose variability indexes of the combined group were lower than those of the control group,and the differences were statistically significant(all P<0.05).In the combined group,the fasting insulin score was(7.43±1.97)mIU/L,which was higher than(5.88±1.85)mIU/L in the control group;the isletβcell function index score of the combined group was 46.03±8.96,which was higher than that of the control group 38.58±6.74;the insulin resistance index score of the combined group was 1.73±0.47,which was lower than that of the control group 2.08±0.33,and the differences were statistically significant(t=4.056,4.698,4.310,all P<0.05).The adverse reactions in the combined group were lower than those in the control group,and the difference was not statistically significant(P>0.05).Conclusion The use of empagliflozin combined with metformin in the treatment of T2DM patients is efficient and safe.It can regulate blood glucose levels,enhance blood glucose control,improve islet function,and reduce insulin resistance.