沙格列汀联合胰岛素治疗老年2型糖尿病频发低血糖病人的疗效评价  

Effect of saxagliptin combined with basal insulin in elderly patients with type 2 diabetes accompanying hypoglycemia

作　　者：杨轶青 陶然 江慧 刘洋 蒋慧君[2] 

机构地区：[1]南京市玄武医院内分泌科,江苏省南京市210018 [2]南京市玄武区红山社区卫生服务中心,江苏省南京市210028

出　　处：《实用老年医学》2017年第9期869-871,共3页Practical Geriatrics

摘　　要：目的探讨沙格列汀联合胰岛素治疗老年2型糖尿病频发低血糖病人的安全性、有效性。方法对比经沙格列汀联合胰岛素治疗的14例2型糖尿病病人治疗前后低血糖发生频率,就其治疗前后血糖、糖化血红蛋白、胰岛素用量、胰高血糖素等变化进行综合分析。结果沙格列汀联合基础胰岛素治疗6月,未观察到明显不良反应,病人低血糖发生频率从(5.14±2.57)次/月减少为(1.79±1.25)次/月(P<0.001);胰岛素用量从(29.1±10.4)U/d减少为(24.4±12.5)U/d(P<0.001);空腹血糖由(9.48±3.38)mmol/L降至(7.19±1.60)mmol/L(P<0.001),餐后2 h血糖由(14.20±6.29)mmol/L降至(11.00±3.52)mmol/L(P<0.001);糖化血红蛋白由(8.69±1.88)%降至(7.45±0.72)%(P<0.001);C肽、胰高血糖素治疗前后差异无统计学意义。结论沙格列汀联合胰岛素治疗频发低血糖的老年2型糖尿病是安全且有效的。Objective To investigate the safety,effects of saxagliptin combined with basal insulin in the treatment of elderly patients with type 2 diabetes accompanying with frequent episodes of hypoglycemia. Methods Before and after treatment,the clinical data of patients treated by saxagliptin and basal insulin,including the frequency of hypoglycemia,the level of glucose,HbA1c,glucagon,and insulin dosage were analyzed. Results After 6 months treatment,the frequency of hypoglycemia reduced from（ 5. 14 ± 2. 57） times per month to（ 1. 79 ± 1. 25） times per month（ P 0. 001）; dosage of insulin reduced from（ 29. 1 ± 10. 4） U/d to（ 24. 4 ± 12. 5） U/d（ P 0. 001）; the level of FPG declined from（ 9. 48±3. 38） mmol/L to（ 7. 19±1. 60） mmol/L（ P〈0. 001）; 2h PG declined from（ 14. 2±6. 29）mmol/L to（ 11. 0 ± 3. 52） mmol/L（ P 0. 001）; HbA1c declined from（ 8. 69 ± 1. 88） % to（ 7. 45 ±0. 72） %（ P〈0. 001） with no side effect. There were no statistical difference in the levels of glucagon and C-peptide before and after treatment. Conclusions Saxagliptin combined with basal insulin used in elderly type 2 diabetes accompanying hypoglycemia is safe and effective.

关 键 词：沙格列汀 基础胰岛素 低血糖 2型糖尿病 

分 类 号：R587.1[医药卫生—内分泌]