CAJ | 학술논문

目的探讨胰岛素联合西格列汀治疗单用胰岛素血糖控制不佳的2型糖尿病患者的临床疗效.方法将80例单用胰岛素、体质量指数(BMI) ≥24 kg/m2、血糖控制不理想的2型糖尿病患者抽签法分成两组:联合组(胰岛素+西格列汀)40例,在使用胰岛素的基础上应用西格列汀100 mg/d口服,根据血糖水平适时调整胰岛素用量；胰岛素组40例,继续应用胰岛素治疗.比较治疗12周后两组患者的体质量指数(BMI)、空腹血糖(FBG)、餐后2h血糖(2 h PBG)、糖化血红蛋白(HbA1c)、胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)、胰岛素用量及低血糖发生率的变化.结果治疗12周后,两组血糖、HbA1c、HOMA-IR均下降；HOMA-β升高；胰岛素组BMI增加,联合组BMI未增加,两组间同期比较差异有统计学意义(P＜0.05)；治疗12周后,联合组胰岛素用量减少,而胰岛素组用量继续增加,组间同期及组内治疗前后比较差异均有统计学意义(P＜0.05).结论胰岛素治疗血糖控制不理想的2型糖尿病患者加用西格列汀可使血糖得到良好控制,同时可以减少胰岛素剂量,减少低血糖发生率,不增加体质量,更好地控制血糖,治疗安全有效.
목적 탐토이도소연합서격렬정치료단용이도소혈당공제불가적2형당뇨병환자적림상료효.방법 장80례단용이도소、체질량지수(BMI) ≥24 kg/m2、혈당공제불이상적2형당뇨병환자추첨법분성량조:연합조(이도소+서격렬정)40례,재사용이도소적기출상응용서격렬정100 mg/d구복,근거혈당수평괄시조정이도소용량；이도소조40례,계속응용이도소치료.비교치료12주후량조환자적체질량지수(BMI)、공복혈당(FBG)、찬후2h혈당(2 h PBG)、당화혈홍단백(HbA1c)、이도β세포공능지수(HOMA-β)、이도소저항지수(HOMA-IR)、이도소용량급저혈당발생솔적변화.결과 치료12주후,량조혈당、HbA1c、HOMA-IR균하강；HOMA-β승고；이도소조BMI증가,연합조BMI미증가,량조간동기비교차이유통계학의의(P＜0.05)；치료12주후,연합조이도소용량감소,이이도소조용량계속증가,조간동기급조내치료전후비교차이균유통계학의의(P＜0.05).결론 이도소치료혈당공제불이상적2형당뇨병환자가용서격렬정가사혈당득도량호공제,동시가이감소이도소제량,감소저혈당발생솔,불증가체질량,경호지공제혈당,치료안전유효.
Objective To explore the clinical effect of sitagliptin combined insulin compared to those patients whose sugars were not well controlled by insulin alone.Methods The eighty type 2 Diabetes patients whose BMI≥24 kg/m2 and used insulin alone were randomly divided into sitagliptin combined insulin group (40 cases) who were given sitagliptin 100mg/d allied with insulin,an insulin group (40 cases) who were given insulin alone.After 12 weeks,the change of body mass index (BMI),fasting plasma glucose (FPG),2 h postprandial blood glucose (2 h PBG),glycosylated hemoglobin (HbA1 c),β-cell function index(HOMA-β),insulin resistance index (HOMA-IR),insulin quantities,and hypoglycemia rates were observed in two groups.Results Compared with pretherapy,the levels of FPG,2 h BG,HbAlc,HOMA-IR,and hypoglycemia rates were significantly decreased (P ＜0.05) ; BMI was increased in insulin group,while was not increased in sitagliptin combined insulin group.After the treatment,the insulin quantities were decreased in the combined group while increased in the control group (P ＜ 0.05).Conclusions Sitagliptin combined insulin can effectively control glucose levels of type 2 diabetes patients,decrease the insulin quantities and the risk of hypoglycemia,and does not increase the weight.