胰岛素治疗血糖控制不佳的2型糖尿病患者联合达格列净的疗效及安全性  

Curative Effect and Safety of Insulin Combined with Dapagliflozin in Treatment of Type 2 Diabetes Patients with Bad Blood Glucose Control

作　　者：陈晓蕾[1] 贾农[1] 杨林[1] 蔡丽萍[1] 夏连丽 杨锐林 宋琳 CHEN Xiao-lei;JIA Nong;YANG Lin;CAI Li-ping;XIA Lian-li;YANG Rui-lin;SONG Lin(Department of Endocrinology, Kunming First People爷s Hospital, Kunming, Yunnan Province, 650031 China)

机构地区：[1]昆明市第一人民医院内分泌科,云南昆明650031

出　　处：《糖尿病新世界》2017年第22期64-66,共3页Diabetes New World Magazine

摘　　要：目的探讨胰岛素治疗血糖控制不佳的2型糖尿病患者联合SGLT-2抑制剂的疗效和安全性。方法选取于2017年5-7月该院收治的60例糖化血红蛋白(HbA1c)≥9.0%的2型糖尿病患者随机分为联合组(n=32)和胰岛素组(n=28),观察治疗12周前后空腹血糖(FPCG)、餐后血糖(PPG)、糖化血红蛋白(HbA1c)、体重指数(BMI)、尿酸(UA)以及血压(BP)、血脂变化,比较两组胰岛素日用量、达标时间(Time)和低血糖发生次数(n)等其他不良反应情况。结果两组心肺肝肾功能无明显异常。两组HbA1c较治疗前明显下降(P<0.05),联合组在FPG、BMI、UA、TG、LDL-C、SBP、DBP,低血糖次数皆明显低于胰岛素组(P<0.05),血糖达标时间、胰岛素日用量显著降低(P<0.01)。结论胰岛素联合SGLT-2抑制剂,效果明显优于单纯胰岛素治疗。且中心性肥胖、血压,血脂及尿酸得以改善,胰岛素日计量及低血糖反应减少,并可能有降糖之外的心血管获益,值得临床推广。Objective To study the curative effect and safety of insulin combined with SGLT-2inhibitor in treatment of type2diabetes patients with bad blood glucose control.Methods60cases of type2diabetes patients whose(HbA1c)≥9.0%from our hospital which selected from May to July2017were randomly divided into two groups,including the combined group(n=32)and insulin group(n=28),and the FPG,PPG,HbA1c,BMI,UA,BP and blood liquid changes in12weeks before and after treatment were observed,and the daily dose of insulin,standards-reaching time and occurrence frequency of hypoglycemia and other adverse reactions were compared between the two groups.Results There were no obvious abnormalities in the cardiopulmonary liver and kidney function,and the HbA1c of the two groups obviously decreased compared with that before treatment(P<0.05),and the FPG,BMI,UA,TG,LDL-C,SBP,DBP,hypoglycemia frequency in the combined group were obviously lower than those in the insulin group(P<0.05),and the blood glucose standards-reaching time and daily dosage of insulin obviously decreased(P<0.05).Conclusion The effect of insulin combined with SGLT-2inhibitor is obviously better than that of single insulin therapy,which can improve the central obesity,blood pressure,blood liquid and uric acid and reduce the daily dose of insulin and hyporglycemia reactions,and it may benefit the cardiovascular organs,and it is worth clinical promotion.

关 键 词：2型糖尿病 钠-葡萄糖协同转运蛋白2(SGLT-2)抑制剂 胰岛素 

分 类 号：R587.1[医药卫生—内分泌]