摘要
目的观察德谷胰岛素联合西格列汀在老年2型糖尿病(T2DM)中的应用效果。方法选取2019年4月-2020年4月在南京中医药大学附属医院治疗的老年T2DM住院患者90例,使用随机数字表法将患者分为观察组和对照组,每组45例。经脱落剔除后得到观察组43例和对照组40例。另选未接受胰岛素治疗的30例患者作为阳性对照组,同期30例健康体检者为阴性对照组。阳性对照组给予二甲双胍联合西格列汀治疗,观察组和对照组在阳性对照组治疗的基础上分别加用德谷胰岛素或甘精胰岛素。12周后评估并比较各组治疗前后血糖水平[空腹血糖(FPG)、餐后2h血糖(2hPBG)]、糖化血红蛋白(HbAlc)和体重指数(BMI);观察并比较观察组和对照组胰岛素应用情况和低血糖发生情况。结果治疗12周后,观察组和对照组FPG、2hPBG、HbAlc和BMI水平均显著低于同组治疗前及阳性对照组(P<0.05),但2组差异无统计学意义(P>0.05);观察组每周胰岛素用量及注射次数均显著低于对照组(P<0.05),夜间非严重低血糖发生率显著低于对照组(P<0.05)。结论老年T2DM患者采用德谷胰岛素联合西格列汀治疗,血糖控制效果良好,较甘精胰岛素联合西格列汀治疗能减少胰岛素用量及注射次数,降低低血糖风险。
Objective To observe the application effects of insulin degludec combined with sitagliptin on type 2 diabetes mellitus(T2DM)in the elderly.Methods 90 elderly patients with T2DMhospitalized in Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from April 2019 to April 2020 were selected and divided into observation group and control group according to the random number table method,with 45 cases in each group.After excluding the patients who lost follow-up,there were 43 cases in the observation group and 40 cases in the control group.Another 30 T2DMpatients who did not receive insulin treatment were selected as the positive control group,and 30 healthy persons who received a health examination during the same period were selected as the negative control group.The positive control group was treated with metformin combined with sitagliptin,and the observation group and control group were treated with insulin deglubber or insulin glargine on the basis of the positive control group.After 12 weeks of treatment,the blood glucose levels[fasting blood glucose(FPG),2h postprandial blood glucose(2hPBG)],glycosylated hemoglobin(HbAlc)and body mass index(BMI)before and after treatment were compared among the four groups;the insulin dosage and occurrence of hypoglycemia were observed and compared between the observation group and the control group.Results After 12 weeks of treatment,the levels of FPG,2hPBG,HbAlc and BMI of the observation group and control group were significantly lower than those before treatment and those of positive control group(P<0.05),but there were no significant differences between the observation group and control group groups(P>0.05).The weekly insulin dosage and injection times of the observation group were significantly lower than those of the control group(P<0.05),and the incidence of non-severe hypoglycemia at night was significantly lower than that of the control group(P<0.05).Conclusion Combination of insulin degludec combined with sitagliptin has a good effect on the blood glucose control in elderly patients with T2DM.Compared with insulin glargine combined with sitagliptin,it can reduce the dosage of insulin and injection times,and reduce the risk of hypoglycemia.
作者
阮园
查敏
叶丽芳
张舒
贾佳
王丽娟
徐巍龙
余旭
Ruan Yuan;Zha Min;Ye Lifang;Zhang Shu;Jia Jia;Wang Lijuan;Xu Weilong;Yu Xu(Department of Endocrinology,Affiliated Hospital(Hospital of Traditional ChineseMedicine of Jiangsu Province)of Nanjing University of Traditional Chinese Medicine,Nanjing,Jiangsu 210029,P.R.China)
出处
《老年医学与保健》
CAS
2020年第6期1000-1003,共4页
Geriatrics & Health Care
基金
国家自然科学基金项目资助(81803908)
江苏省第十四批“六大人才高峰”高层次人才选拔培养项目资助(WSN-088)。
关键词
老年
2型糖尿病
西格列汀
德谷胰岛素
甘精胰岛素
elderly
type 2 diabetes mellitus
sitagliptin
insulin glargine
insulin degludec
