胰岛素泵联合二肽基肽酶-Ⅳ抑制剂治疗新发2型糖尿病的疗效观察

摘要

目的 探讨胰岛素泵联合二肽基肽酶-Ⅳ(DPP-Ⅳ)抑制剂治疗新诊断2型糖尿病(T2DM)的效果.方法 将51例新诊断T2DM患者随机分为试验组(胰岛素泵联合DPP-Ⅳ抑制剂)与对照组(单用胰岛素泵).治疗15 d后比较2组临床疗效.结果 治疗后,2组血糖相关指标均显著改善(P ＜0.05),且试验组血糖控制显著优于对照组(P ＜0.05).试验组胰岛β细胞功能指数、C肽曲线下面积、胰岛素抵抗指数显著优于对照组(P ＜0.05).试验组胰岛素用量、血糖完全达标比例、血糖达标时间、体质量增加值均显著优于对照组(P ＜0.01).试验组低血糖发生率为8.00％(2/26),对照组为12.00％(3/25),2组差异无统计学意义(P＞ 0.05).治疗过程中,2组均未发生严重低血糖事件以及肝、肾功能损害.结论 胰岛素泵联合DPP-Ⅳ抑制剂治疗新诊断T2DM的效果显著,能有效控制血糖,减轻胰岛素抵抗,减少体质量增加.%Objective To investigate the effect of insulin pump combined with dipeptidyl peptidase-Ⅳ (DPP-Ⅳ) inhibitor on the treatment of newly diagnosed type 2 diabetes mellitus (T2 DM). Methods Totally 51 newly diagnosed patients with T2 DM were randomly divided into experimental group (insulin pump combined with DPP-Ⅳ inhibitor) and control group (insulin pump alone). After 15 days of treatment, the clinical effect was compared between two groups. Results After treatment, the blood sugar related indexes in both groups significantly improved (P ＜ 0. 05), and the blood sugar control of the experimental group was significantly better than that of the control group (P ＜ 0. 05). The pancreatic β cell function index, area under curve of C-peptide and insulin resistance index in the experimental group were significantly better than those in the control group (P ＜0. 05). The dosage of insulin, the ratio of patients with blood sugar reaching the standard completely, the time of blood sugar reaching the standard and the increase value of body mass in the experimental group were significantly better than those in the control group (P ＜ 0. 01). The incidence rate of hypoglycemia was 8. 00％ (2/26) in the experimental group and 12. 00％ (3/25) in the control group, and there was no significant difference between the two groups (P＞ 0. 05). During the treatment, no severe hypoglycemic events and liver and kidney function damage occurred in both groups. Conclusion Insulin pump combined with DPP-Ⅳ inhibitor is effective in the treatment of newly diagnosed T2 DM, which can effectively control blood sugar, reduce insulin resistance and weight gain.