达格列净联合甘精胰岛素治疗 2 型糖尿病患者的 疗效及对血糖变异性、胰岛功能的影响. (Chinese)

Efficacy of Dapagliflozin Combined with Insulin Glargine in the Treatment of Patients with Diabetes Mellitus Type 2 and Its Effects on Blood Glucose Variability and Pancreatic Islet Function. (English)

OBJECTIVE: To probe into the efficacy of dapagliflozin combined with insulin glargine in the treatment of patients with diabetes mellitus type 2 (T2DM) and its effects on blood glucose variability and pancreatic islet function. METHODS: A total of 98 patients with T2DM admitted into the hospital from Jan. 2019 to Jan. 2023 were divided into the observation group and control group via the simple randomized grouping method, with 49 cases in each group. The control group was treated with insulin glargine; while the observation group was given dapagliflozin combined with insulin glargine. After 3 months of treatment, the clinical efficacy, blood glucose indicators, blood glucose variability, pancreatic islet function indicators and blood lipid indicators before treatment and after 3 months of treatment, the incidences of adverse drug reactions were compared between two groups. RESULTS: After 3 months of treatment, the total effective rate of the observation group [98. 0%(48/49)] was significantly higher than that of the control group [85. 7%(42/ 49)], with statistically significant difference (P<0. 05). After 3 months of treatment, the fasting blood glucose, 2 h postprandial blood glucose, glycosylated hemoglobin, 24 h mean blood glucose, maximum amplitude of blood glucose, mean amplitude of glycemic excursions in 1 d, variable coefficient of blood glucose, variable coefficient of fasting blood glucose, insulin resistance index, total cholesterol, low-density lipoprotein cholesterol and triglyceride levels in both groups were significantly lower than those before treatment, and the observation group was significantly lower than the control group, with statistically significant differences (P<0. 05); the homeostasis model assessment-β, insulin sensitivity index and high-density lipoprotein cholesterol of both groups were significantly higher than those before treatment, and the observation group was higher than the control group, with statistically significant differences (P<0. 05). During the treatment period, the total incidences of adverse drug reactions of the observation group and the control group were respectively 22. 4% (11/49) and 10. 2% (5/49), the difference was not statistically significant (P>0. 05). CONCLUSIONS: Dapagliflozin combined with insulin glargine has significant efficacy in the treatment of patients with T2DM, which can significantly improve blood glucose control, enhance pancreatic islet function and regulate blood lipid levels with higher safety. [ABSTRACT FROM AUTHOR]

目的: 探究达格列净联合甘精胰岛素治疗 2 型糖尿病 (T2DM) 患者的疗效及对血糖变异性、胰岛功能的影响。方法: 按 简单随机化分组法, 将 2019 年 1 月至 2023 年 1 月该院就诊的 98 例 T2DM 患者分为观察组和对照组, 各 49 例。对照组患者予以 甘精胰岛素治疗; 观察组患者予以达格列净联合甘精胰岛素治疗。治疗 3 个月后, 比较两组患者的临床疗效, 治疗前和治疗 3 个 月后的血糖指标、血糖变异性、胰岛功能指标和血脂指标, 以及治疗期间不良反应发生情况。结果: 治疗 3 个月后, 观察组患者的 临床总有效率 [98. 0%(48/49)] 显著高于对照组 [85. 7% (42/49)], 差异有统计学意义 (P<0. 05)。治疗 3 个月后, 两组患者的空 腹血糖、餐后 2 h 血糖、糖化血红蛋白、24 h 平均血糖、最大血糖幅度、1 d 内平均血糖波动幅度、血糖变异系数、空腹血糖系数、胰 岛素抵抗指数、总胆固醇、低密度脂蛋白胆固醇、三酰甘油水平均较治疗前显著降低, 且观察组患者低于同期对照组, 差异均有统 计学意义 (P<0. 05); 两组患者的胰岛 β 细胞功能指数、胰岛素敏感性检测指数、高密度脂蛋白胆固醇水平均较治疗前显著提高, 且观察组患者高于同期对照组, 差异均有统计学意义 (P<0. 05)。在治疗期间, 观察组、对照组患者不良反应总发生率分别为 22. 4%(11/49)、10. 2%(5/49), 两组的差异无统计学意义 (P>0. 05)。结论: 采用达格列净联合甘精胰岛素治疗 T2DM 患者具有 显著疗效, 可显著改善血糖控制, 提高胰岛功能, 调节血脂水平, 同时具有较好的安全性。 [ABSTRACT FROM AUTHOR]

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