恩格列净联合胰岛素强化治疗肥胖2型糖尿病患者的疗效与安全性  

Efficacy and safety of empagliflozin combined with insulin intensive therapy for obesity type 2 diabetes mellitus

作　　者：彭湾湾 薛君力[1] PENG Wanwan;XUE Junli(Department of Endocrinology,Jingzhou Central Hospital,Hubei 434020,China)

机构地区：[1]荆州市中心医院内分泌科

出　　处：《实用医学杂志》2019年第20期3223-3226,共4页The Journal of Practical Medicine

基　　金：湖北省自然科学基金资助项目(编号：2017CPB736)

摘　　要：目的探讨恩格列净(empagliflozin,EMPA)联合胰岛素强化治疗超重/肥胖、胰岛功能受损、血糖控制欠佳的2型糖尿病(type 2 diabetes mellitus,T2DM)患者的临床疗效与安全性。方法采用随机、单盲、安慰剂对照前瞻性研究。选取80例T2DM患者,随机分为恩格列净组(恩格列净联合强化胰岛素)和对照组(强化胰岛素联合复合维生素),每组40例,疗程12周。观察两组患者治疗前后空腹血糖(FBG)、餐后2 h血糖(2hBG)、糖化血红蛋白(HbA1c)、血脂、血压、体质量指数(BMI)、血糖达标时间、胰岛素每日用量的变化以及安全性差异。结果恩格列净组治疗后FBG、2hBG、HbA1c、BMI、血脂、血压、血糖达标时间、胰岛素每日用量均低于对照组(P<0.01),而两组不良反应差异无统计学意义(P>0.05)。结论在超重/肥胖、胰岛功能受损、血糖控制欠佳的T2DM患者中,恩格列净联合胰岛素强化治疗可以有效降低血糖、BMI,改善血脂、降低血压,减少胰岛素用量及缩短血糖达标时间,且安全性较好。Objective To investigate the clinical efficacy and safety of empagliflozin combined with insu lin intensive treatment of type 2 diabetes mellitus(T2DM)with overweight/obesity,impaired islet function and poor glycemic control.Methods In this randomized,single blind,placebo controlled study,80 patients with T2DM were randomly divided intoempagliflozin group(empagliflozin combined with intensive insulin)and control group(intensive insulin combined with vitamins),and treated for 12 weeks.The changes of fasting blood glucose(FBG),2 h postprandial blood glucose(2hBG),glycosylated hemoglobin(HbA1c),blood lipid,blood pres sure,body mass index(BMI),time of blood sugar reaching the standard,daily dosage of insulin and safety differences between the two groups were observed before and after treatment.Results After treatment,these clinical indexes were lower in the empagliflozin group than those in the control group(P<0.01),but there was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion In T2DM patients with overweight/obesity,impaired islet function and poor glycemic control,intensive insulin therapy combined with empagliflozin have better safety and can effectively reduce blood sugar and BMI,improve blood lipids,reduce blood pressureand insulin dosage,shorten the time of blood sugar reaching the standard,and has better safety.

关 键 词：恩格列净 2型糖尿病 强化降糖治疗 超重/肥胖 

分 类 号：R58[医药卫生—内分泌]