CAJ | 학술논문

目的：探讨西格列汀联合预混胰岛素对2型糖尿病患者血糖波动的影响。方法将42例2型糖尿病患者随机分为对照组21例和试验组21例。对照组予以门冬胰岛素30，每日2～3次注射至达标；试验组予以门冬胰岛素30，每日2～3次注射＋西格列汀100 mg，每日1次口服至达标。通过指尖血糖监测和动态血糖监测（ CGM）评估血糖波动，比较2组治疗前后血糖波动指标的变化以及不良反应的发生率。结果治疗后，2组血糖波动指标较治疗前均明显下降。指尖血糖结果显示：治疗后，试验组日内血糖水平标准差、变异系数和餐后血糖波动幅度均低于对照组（ P＜0.05）。动态血糖监测系统结果显示：治疗后，试验组日内血糖水平标准差（1.77±0.53） mmol · L－1低于对照组（2.39±0.80） mmol· L－1（P＜0.05）；试验组平均血糖波动幅度（4.36±1.14）mmol· L－1和日间血糖平均绝对差（1.32±0.37） mmol · L－1低于对照组平均血糖波动幅度（5.82±2.44）mmol· L－1和日间血糖平均绝对差（1.71±0.65）mmol· L－1，但差异无统计学意义（P＞0.05）；试验组低血糖时间比（0.86±1.58）％低于对照组（2.95±2.39）％（ P ＜0.05）。治疗过程中2组患者均未出现药品不良反应。结论西格列汀联合预混胰岛素能有效降低血糖，减少血糖波动，而且更安全方便。
목적：탐토서격렬정연합예혼이도소대2형당뇨병환자혈당파동적영향。방법장42례2형당뇨병환자수궤분위대조조21례화시험조21례。대조조여이문동이도소30，매일2～3차주사지체표；시험조여이문동이도소30，매일2～3차주사＋서격렬정100 mg，매일1차구복지체표。통과지첨혈당감측화동태혈당감측（ CGM）평고혈당파동，비교2조치료전후혈당파동지표적변화이급불량반응적발생솔。결과치료후，2조혈당파동지표교치료전균명현하강。지첨혈당결과현시：치료후，시험조일내혈당수평표준차、변이계수화찬후혈당파동폭도균저우대조조（ P＜0.05）。동태혈당감측계통결과현시：치료후，시험조일내혈당수평표준차（1.77±0.53） mmol · L－1저우대조조（2.39±0.80） mmol· L－1（P＜0.05）；시험조평균혈당파동폭도（4.36±1.14）mmol· L－1화일간혈당평균절대차（1.32±0.37） mmol · L－1저우대조조평균혈당파동폭도（5.82±2.44）mmol· L－1화일간혈당평균절대차（1.71±0.65）mmol· L－1，단차이무통계학의의（P＞0.05）；시험조저혈당시간비（0.86±1.58）％저우대조조（2.95±2.39）％（ P ＜0.05）。치료과정중2조환자균미출현약품불량반응。결론서격렬정연합예혼이도소능유효강저혈당，감소혈당파동，이차경안전방편。
Objective To investigate the effects of sitagliptin combined with premixed insulin on blood glucose fluctuations in patients with type 2 diabetes.Methods A total of 42 patients with type 2 diabetes from April 2012 to November 2013 were randomly divided into two groups, treated with insulin aspart 30 injections alone 2 to 3 times a day( control group, n=21 ) or combined with oral sitagliptin once a day ( treatment group, n=21).The glucose fluctuations by fingertip blood glucose and continuous glucose monitoring ( CGM) were assessed and the changes of glucose fluctuations in two groups before and after treatment were com-pared as well as the incidence of adverse reactions.Results Compared with before treatment, the data of blood glucose fluctuations index in two groups were significantly decreased after treatment.The fingertip blood glucose results showed that standard deviation of blood glucose( SDBG) , coefficient of varicotion( CV) and postprandial blood glucose index were lower in treatment group after treatment(P<0.05).The date from CGM showed SDBG [(1.77 ±0.53) vs ( 2.39 ±0.80 ) mmol · L-1 ], was significantly lower in treatment group than that in control group( P<0.05).MAGE and MODD in treatment group was decreased than control group [ MAGE ( 4.36 ±1.14 ) vs ( 5.82 ±2.44 ) mmol · L-1 and MODD ( 1.32 ±0.37 ) vs (1.71 ±0.65)mmol· L-1], but there was no statistical difference found(P >0.05).Hypoglycemia time ratio in treatment group was lower than that in control group [ ( 0.86 ±1.58 )% vs ( 2.95 ±2.39 )%, P <0.05 ].Conclusion Sitagliptin combined with premixed insulin is more safe and convenient for reducing blood glucose level and glucose fluctuations.