CAJ | 학술논문

目的:探讨基础胰岛素(甘精胰岛素,商品名来的适,赛诺菲安万特公司生产)联合二肽基肽酶4抑制剂(磷酸西格列汀,商品名捷诺维,默沙东公司生产)治疗单用基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120例单用基础胰岛素、体重指数(BMI)≥26、血糖控制不理想的2型糖尿病患者随机分成两组:(甘精胰岛素+西格列汀)组60例,在使用甘精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基础胰岛素用量;基础胰岛素组60例,继续应用甘精胰岛素治疗.观察治疗前、治疗后8周、12周两组患者的体重指数(BMI)、空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)、胰岛素用量的改变.结果:治疗后8、12周时,两组血糖、HbA1C均有下降;8周时,基础胰岛素组BMI增加,基础胰岛素+西格列汀组体重增加不明显,两组间同期比较差异有统计学意义,组内治疗前后胰岛素组比较差异有统计学意义(P<0.05或P<0.01);治疗8周时,甘精胰岛素+西格列汀组胰岛素用量减少,而基础胰岛素组用量继续增加,治疗12周时,甘精胰岛素+西格列汀组胰岛素用量进一步减少,组间同期及组内治疗前后比较均有统计学意义(P<0.05或P<0.01).结论:基础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,更好地控制血糖,减少低血糖的发生,治疗安全有效.
목적:탐토기출이도소(감정이도소,상품명래적괄,새낙비안만특공사생산)연합이태기태매4억제제(린산서격렬정,상품명첩낙유,묵사동공사생산)치료단용기이도소혈당공제불가적2형당뇨병환자적림상료효.방법:장120례단용기출이도소、체중지수(BMI)≥26、혈당공제불이상적2형당뇨병환자수궤분성량조:(감정이도소+서격렬정)조60례,재사용감정이도소적기출상응용서격렬정100 mg/d구복,근거혈당수평괄시조정기출이도소용량;기출이도소조60례,계속응용감정이도소치료.관찰치료전、치료후8주、12주량조환자적체중지수(BMI)、공복혈당(FBG)、찬후2 h혈당(2 h PG)、당화혈홍단백(HbA1c)、이도소용량적개변.결과:치료후8、12주시,량조혈당、HbA1C균유하강;8주시,기출이도소조BMI증가,기출이도소+서격렬정조체중증가불명현,량조간동기비교차이유통계학의의,조내치료전후이도소조비교차이유통계학의의(P<0.05혹P<0.01);치료8주시,감정이도소+서격렬정조이도소용량감소,이기출이도소조용량계속증가,치료12주시,감정이도소+서격렬정조이도소용량진일보감소,조간동기급조내치료전후비교균유통계학의의(P<0.05혹P<0.01).결론:기출이도소치료혈당공제불이상적2형당뇨병환자가용서격렬정가사혈당득도량호공제,동시가이감소이도소제량,경호지공제혈당,감소저혈당적발생,치료안전유효.
Objective:To explore the clinical effects of basal insulin(Insulin Glargine,Product Name:Lantus,By:Sanofi-Aventis)combined with Dipeptidyl peptidase-4 inhibitors(Phosphate Sitagliptin,product name:Propharm,By Merck Sharp&Dohme,MSD)in treating typeⅡdiabetes without good blood glucose level control by only giving basal insulin.Method:120 cases of typeⅡdiabetes patients which were treated only with basal insulin,with body mass index(BMI)≥26 and not well controlled blood glucose level were randomized into two groups:(Insulin Glargine+Sitagliptin group,60 cases),in which Sitagliptin was orally taken at a dosage of 100 mg/d besides applying of Insulin Glargine and the does of Insulin Glargine applied was adjusted according to the patients’blood glucose levels;Insulin Glargine group(60 cases),for which applying of Insulin Glargine was continued.The BMI,fasting blood glucose(FBG),2 h postprandial blood glucose(2 h PG),Glycosylated hemoglobin(HbA1C)and the changes in applying does of Insulin Glargine were observed 8 and 12 weeks after treatment.Result:The blood glucose and HbA1C levels decreased in both groups 8 and 12 weeks later.8 weeks after treatment,the BMI of patients in Insulin Glargine group increased,and the BMI in Insulin Glargine+Sitagliptin group showed insignificant increase.The differences in BMI changed obtained at the same time point between the two groups were statistically significant,and the differences in BMI changes prior to and after treatment within the Insulin Glargine group were statistically significant(P<0.05 or P<0.01).On the 8th week,the applying dosage of Insulin Glargine in Insulin Glargine+Sitagliptin group decreased while the applying dosage in Sitagliptin group increased. On the 12th week,the applying dosage of Insulin Glargine in Insulin Glargine+Sitagliptin group decreased further more,the differences at the same time point between the two groups and the differences prior to and after treatment within the both groups were statistically significant(P<0.05 or P<0.01). Conclusion:Combining Sitagliptin with Insulin Glargine,better control in blood glucose level could be obtained in typeⅡdiabetes without good blood glucose level control by only giving basal insulin.Besides,the applying does of Insulin Glargin decreases and the blood glucose level is under better control,which decreased the occurrence of Hypoglycemia,hence,treating type Ⅱdiabetes by combining Sitagliptin with Insulin Glargine is safe and effective.