摘要
目的探讨胰岛素强化治疗联合沙格列汀口服对2型糖尿病患者血糖波动的影响。方法选取收住的餐后血糖波动幅度>2.2 mmol/L、病程>5年的2型糖尿病患者200例为研究对象,按照就诊时间随机分为对照组与观察组,每组100例。在健康教育、糖尿病饮食及运动基础上,患者暂停原口服降糖方案,对照组予以胰岛素强化治疗(基础-餐时胰岛素);观察组在胰岛素强化治疗基础上联合沙格列汀5 mg口服,观察住院期间空腹、餐后、睡前血糖及12周后糖化血红蛋白变化,计算血糖波动幅度、胰岛细胞功能指标,记录低血糖反应及严重心血管事件发生情况。结果治疗后观察组患者血糖、血糖波动幅度及胰岛细胞功能等指标差异有统计学意义(P<0.05),治疗后FPG、2 hPG、PPGE、LAGE、SDBG、HbA_(1C)、H0MA-IR较对照组降低(P<0.05),FCP、2 hCP、H0MA-β高于对照组(P<0.05)。治疗后,2组患者低血糖发生差异无统计学意义(P>0.05);治疗期间2组患者均无严重心血管事件发生。结论胰岛素强化治疗联合沙格列汀口服不仅可以降低2型糖尿病患者血糖及长期血糖波动水平,而且能降低短期血糖波动幅度,同时可以保护胰岛细胞功能。胰岛素强化治疗联合沙格列汀对低血糖呈中性,一定程度上能保证治疗的安全性。
Objective To explore the effect of intensive insulin therapy combined with oral saxagliptin on blood glucose fluctuations in patients with type 2 diabetes mellitus.Methods 200 cases of type 2 diabetes patients whose postprandial blood glucose fluctuations>2.2 mmol/L and disease duration greater than 5 years were selected,and were randomly divided into the control group and the observation group with 100 cases in each group.On the base of health education,diabetic diet and exercise,the patient suspended the original oral hypoglycemic regimen,the control group was given intensive insulin therapy(basic-meal insulin),and the observation group was given 5 mg saxagliptin on the basis of intensive insulin therapy.The changes of fasting blood glucose,postprandial blood glucose,blood glucose before sleeping and glycosylated hemoglobin after 12 weeks were observed.The fluctuation of blood glucose and islet cell function were calculated.The hypoglycemia and serious cardiovascular events were recorded.Results After treatment,there were significant differences in blood glucose,blood glucose fluctuation range and islet cell function indexes in the observation group(P<0.05),FPG(7.39±1.63),2hPG(9.09±1.62),PPGE(2.01±1.46),LAGE(3.79±1.82),SDBG(1.70±0.81),HbAlc(6.43±1.69),H0MA-IR(3.03±2.79)were lower than those in the control group(P<0.05).FCP(1.80±0.87),2hCP(1.99±1.08),H0MA-β(66.53±42.37)were higher than those in the control group(P<0.05).After treatment,there was no significant difference in the occurrence of hypoglycemia between the two groups of patients(P>0.05).During the treatment,there were no serious cardiovascular events in the two groups.Conclusion Intensive insulin therapy combined with oral saxagliptin can not only reduce blood glucose and long-term blood glucose fluctuation levels in patients with type 2 diabetes,but also reduce the range of short-term blood glucose fluctuations,while protecting the function of islet cells.It is neutral to hypoglycemia,which can ensure the safety of treatment to a certain extent.
作者
李秀兰
李红梅
LI Xiulan;LI Hongmei(Medical School of Northwest Minzu University,Lanzhou 730030,China;Department of Endocrinology,People's Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,China)
出处
《宁夏医学杂志》
CAS
2021年第6期512-515,共4页
Ningxia Medical Journal
关键词
2型糖尿病
胰岛素强化治疗
沙格列汀
血糖
Type 2 diabetes mel1itus
Intensive insulin therapy
Saxag1iptin
Blood glucose
作者简介
通讯作者:李红梅,Email:lihongmei19630310@163.com。
