吡格列酮二甲双胍片联合甘精胰岛素治疗2型糖尿病患者的疗效研究

Efficacy of Pioglitazone-Metformin Tablets Combined with Insulin Glargine in the Treatment of Patients with Type 2 Diabetes Mellitus

目的探讨吡格列酮二甲双胍片联合甘精胰岛素治疗2型糖尿病(T2DM)患者的疗效及对血清胰岛素样生长因子(IGF-1)、apelin水平、糖脂代谢和胰岛功能的影响。方法选取2021年9月至2023年12月就诊于合肥市第二人民医院的102例T2DM患者作为研究对象,纳入患者按照随机数字表法分为联合组与对照组,每组51例。两组均以甘精胰岛素为干预药物,联合组同时加用吡格列酮二甲双胍片。对两组患者的疗效、糖脂代谢、胰岛功能均进行评估和分析,并统计不良反应发生情况。结果治疗后,联合组总有效率更高,两组差异有统计学意义(P<0.05);两组血清IGF-1、apelin水平均较治疗前升高,且联合组更高(P<0.05);两组空腹血糖(FPG)、糖化血红蛋白(HbA1C)、空腹胰岛素(FINS)水平与治疗前比较均降低,且联合组更低(P<0.05);两组血清甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平均较治疗前下降,血清高密度脂蛋白胆固醇(HDL-C)水平与治疗前比较均升高,且联合组血清TG、TC、LDL-C水平更低,血清HDL-C水平更高(P<0.05);两组胰岛素分泌指数(HOMA-β)水平均较治疗前升高,胰岛素抵抗指数(HOMA-IR)水平均较治疗前下降,且联合组HOMA-β更高,HOMA-IR更低(P<0.05);两组不良反应发生率差异无统计学意义(P>0.05)。结论吡格列酮二甲双胍片联合甘精胰岛素可提高对T2DM患者的治疗效果,增强患者糖脂代谢及胰岛功能的改善效果,且治疗安全性较好。

Objective To investigate the efficacy of pioglitazone-metformin tablets combined with insulin glargine in the treatment of patients with type 2 diabetes mellitus(T2DM),and its effects on serum insulin-like growth factor 1(IGF-1)and apelin levels,glucose and lipid metabolism and islet function.Methods A total of 102 patients with T2DM in the Second People's Hospital of Hefei from September 2021 to December 2023 were included.They were assigned to either the combination group(n=51)or the control group(n=51)using the random number table method.Both groups were treated with insulin glargine injection,and the combination group was additionally given oral administration of pioglitazone-metformin tablets.The therapeutic effects,glucose and lipid metabolism levels,and islet function in each group were evaluated and analyzed.And the incidence of adverse reactions was recorded.Results After treatment,the total effective rate in the combination group was higher than that in the control group,and the difference between the two groups was statistically significant(P<0.05).Serum IGF-1 and apelin levels in both groups increased,and the levels were higher in the combination group(P<0.05).The levels of fasting plasma glucose(FPG),glycated hemoglobin(HbA 1C)and fasting insulin(FINS)in both groups decreased,and the levels were lower in the combination group(P<0.05).Serum triglyceride(TG),total cholesterol(TC)and low-density lipoprotein cholesterol(LDL-C)levels decreased,while serum high-density lipoprotein cholesterol(HDL-C)levels increased in both groups(P<0.05).Serum TG,TC and LDL-C levels in the combination group were lower,and serum HDL-C level in the combination group were higher compared to those in the control group(P<0.05).The homeostasis model assessment of beta-cell function(HOMA-β)increased and homeostasis model assessment of insulin resistance(HOMA-IR)decreased in both groups after treatment(P<0.05).The combination group showed higher HOMA-βand lower HOMA-IR compared to the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Pioglitazone-metformin tablets combined with insulin glargine can enhance the therapeutic effect on patients with T2DM,and improve glucose and lipid metabolism and islet function in patients,with good safety.