沙格列汀联合甘精胰岛素治疗血糖控制不佳2型糖尿病疗效及对血糖波动的影响

摘要

目的 观察沙格列汀联合甘精胰岛素治疗血糖控制不佳2型糖尿病(T2DM)的疗效及对血糖波动的影响.方法 选取医院内分泌科2013年3月至2016年4月诊治的80例血糖控制不佳的T2DM患者,对其临床资料作回顾性分析,根据治疗方式的不同分为观察组和对照组,各40例,观察组采用沙格列汀联合甘精胰岛素治疗,对照组采用格列美脲联合甘精胰岛素治疗.通过动态血糖监测系统(CGMS)监测血糖波动情况,并比较血糖、血脂、血压等指标的变化.结果 两组患者治疗后空腹血糖(FPG)、餐后2 h血糖(2 h PG)等生化指标均较治疗前明显下降(P0.05).两组患者治疗前各CGMS指标比较无明显差异(P>0.05),治疗后,观察组血糖平均波动幅度(MAGE)、血糖波动次数(NGE)、血糖平均绝对差(MODD)值、高血糖曲线下面积(AUC)均较对照组明显下降(P0.05).结论 沙格列汀联合甘精胰岛素治疗血糖控制不佳的T2DM,可有效控制血糖,改善血糖波动,稳定性好,临床疗效显著,且未见明显低血糖事件发生,值得临床推广.%Objective To investigate the effect of Saxagliptin combined with Insulin Glargine on blood glucose fluctuation in T2DM pa-tients with poor blood glucose control. Methods The clinical data of 80 patients with poor blood glucose control were analyzed retro-spectively admitted to our hospital from March 2013 to April 2016. The patients were divided into observation group and control group, 40 cases in each group. The rats in the observation group were treated with salatidine combined with insulin glargine and the control group was treated with glimepiride combined with insulin glargine. Blood glucose fluctuation is monitored by dynamic CGMS,and the blood glucose,blood lipids,blood pressure and other indicators are compared. Results The biochemical indexes of FPG and 2 h PG in the two groups were better than those before treatment(P 0. 05). It could be shown that both drugs were effective in controlling blood sugar. No significant difference was detected in the CGMS indexes between the two groups(P > 0. 05). The levels of MAGE, NGE,MODD and AUC in the observation group were significantly lower than those in the control group after treatment(P 0. 05),indicating that the obser-vation group was superior to the control group in controlling the blood glucose stability,and the risk of hypoglycemia was low. Conclusion Salatrine combined with Insulin Glargine in T2DM patients can effectively control their blood glucose,improve blood glucose fluctuations,control blood glucose in the stability of clinical efficacy,and no significant hypoglycemia occurred. It is worthy of clinical promotion.