摘要
目的探讨曲格列汀联合甘精胰岛素对血糖控制不佳的T2DM患者胰岛β细胞功能和血糖波动的影响。方法通过对我院2014年6月至2017年2月内分泌科就诊治疗的86例血糖控制不佳的T2DM患者临床资料做回顾性分析,并根据治疗方式的不同分为观察组、对照组(即观察组采用曲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各43例),通过动态CGMS监测血糖波动情况,并比较血糖、血脂、血压、HOMA-β及HOMA-IR等指标变化。结果两组患者治疗后FPG、2h PG等生化指标均较治疗前好转,差异有统计学意义(P<0.05),且两组患者治疗后血糖、血脂、血压、胰岛素用量等指标比较差异无统计学意义(P>0.05)。两组患者治疗前各CGMS指标比较差异无统计学意义(P>0.05),治疗后观察组MAGE、NGE、MODD值、高血糖AUC均较对照组下降明显,差异有统计学意义(P<0.05),两组患者SDBG、低血糖AUC比较差异无统计学意义(P>0.05)。两组患者治疗前HOMA-β、HOMA-IR指数比较差异无统计学意义(P>0.05),治疗后两组患者HOMA-β指数均较治疗前升高,且观察组较对照组上升明显,差异有统计学意义(P<0.05);治疗后HOMA-IR指数均较治疗前下降,且观察组较对照组下降明显,差异有统计学意义(P<0.05)。结论曲格列汀联合甘精胰岛素治疗血糖控制不佳的T2DM患者可有效的调节其血糖,改善血糖波动及胰岛β细胞功能,在血糖控制稳定性方面临床疗效显著,且未见明显低血糖事件发生。
Objective To evaluate the effect of trelagliptin combined with insulin glargine on islet β cell function and blood glucose fluctuation in T2 DM patients with poor blood glucose control. Methods A retrospective analysis was made to the clinical data of 86 T2 DM patients with poor blood glucose control diagnosed and treated in our Endocrine Department from June2014 to February 2017.They were divided into observation group（43 cases treated with trelagliptin combined with insulin glargine）and control group（43 cases treated with glimepiride combined with insulin glargine） according to therapies. Blood glucose fluctuation was monitored by dynamic CGMS,and the blood glucose,blood lipids,blood pressure,HOMA-β and HOMA-IR were compared.Results The biochemical indexes of FPG and 2 h PG in the two groups were better than those before treatment（P〈0. 05）.No significant difference was detected in blood glucose,blood lipid,blood pressure and insulin dosage between the two groups（P 〈0. 05）.No significant difference was detected in the CGMS indexes between the two groups（P〈0. 05）.The levels of MAGE,NGE,MODD and hyperglycemic AUC in the observation group were significantly lower than those in the control group after treatment（P〈0. 05）.No significant difference was detected in SDBG and hypoglycemic AUC between the two groups（P〈 0. 05）. No significant difference was detected in HOMA-β and HOMA-IR before treatment（P 〈0. 05）. HOMA-β index in both groups were higher than those before treatment,which was more significant in the observation group（P〈 0. 05）. And HOMA-IR index in both groups were lower than those before treatment,which was more significant in the observation group（P 〈0. 05）. Conclusion Trelagliptin combined with insulin glargine in T2 DM patients with poor blood glucose control can effectively control their blood glucose,improve blood glucose fluctuations and islet β cell function and control blood glucose in the stability of clinical efficacy without significant hypoglycemia occurring.
出处
《四川医学》
CAS
2017年第10期1171-1175,共5页
Sichuan Medical Journal
关键词
曲格列汀
甘精胰岛素
血糖控制不佳T2DM患者
血糖波动
胰岛Β细胞功能
trelagliptin
insulin glargine
T2DM patients with poor blood glucose control
blood glucose fluctuations
islet p cell function
