二甲双胍、达格列净、司美格鲁肽治疗血糖控制不佳2型糖尿病的临床研究

Clinical study of metformin,dapagliflozin and semaglutide in the treatment of type 2 diabetes mellitus with poor blood glucose control

目的探讨二甲双胍、达格列净、司美格鲁肽治疗血糖控制不佳2型糖尿病(T2DM)的应用价值。方法选取2021年6月至2023年12月在东莞康华医院医治的92例血糖控制不佳T2DM患者为研究对象。采用随机数表法将患者分为观察组和对照组,每组各46例。对照组采用二甲双胍联合达格列净治疗;观察组采用二甲双胍、达格列净、司美格鲁肽联合治疗。检测并比较两组血糖指标、体格指标、胰岛功能指标和不良反应发生情况。结果观察组治疗后的空腹血糖、餐后2 h血糖和糖化血红蛋白均明显低于对照组,差异有统计学意义(P<0.05)。与对照组比较,观察组治疗后的体重明显减轻,体重指数和腰围均明显减小,差异有统计学意义(P<0.05)。与对照组比较,观察组治疗后的胰岛素β细胞分泌功能指数明显升高,胰岛素β细胞抵抗指数明显降低,差异有统计学意义(P<0.05)。结论二甲双胍、达格列净、司美格鲁肽治疗控制不佳T2DM可更有效地控制血糖水平、减轻体重和改善胰岛功能。

Objective To investigate the clinical value of metformin,dapagliflozin and semaglutide in the treatment of type 2 diabetes mellitus(T2DM)with poor blood glucose control.Methods A total of 92 T2DM patients with poor blood glucose control who were treated at Dongguan Kanghua Hospital from June 2021 to December 2023 were selected as the study subjects.The patients were divided into an observation group and a control group using a random number table method,with 46 cases in each group.The control group was treated with metformin combined with dapagliflozin.The observation group was treated with a combination of metformin,dapagliflozin and semaglutide.The blood glucose index,physical index,pancreatic function index,and occurrence of adverse reactions between the two groups were compared.Results After treatment,fasting blood glucose,2 h postprandial blood glucose and glycosylated hemoglobin in the observation group were significantly lower than those in the control group,with statistically significant differences(P<0.05).Compared with the control group,the observation group had significantly lighter body weight,significantly smaller body mass index and waist circumference after treatment,and the difference was statistically significant(P<0.05).Compared with the control group,the observation group showed a significantly higher ncreaticβcell function index and a significantly lower homeostasis model assessment of insulin resistance after treatment,with a statistically significant difference(P<0.05).Conclusion Metformin,dapagliflozin and semaglutide can effectively control blood glucose levels,reduce weight,and improve pancreatic function in T2DM with poor blood glucose control.