不同口服降糖药对2型糖尿病胰岛素泵强化治疗患者胰岛功能及预后的影响  

Effects of different oral hypoglycemic agents on pancreatic islet function and prognosis of type 2 diabetic patients treated with insulin pump

作　　者：许桂煌 张莹[2] 郑思远[2] 刘恩[2] 罗恒聪 XU Guihuang;ZHANG Ying;ZHENG Siyuan;LIU En;LUO Hengcong(Guangzhou Medical University, Guangzhou 516000, China;Department of Endocrinology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510145, China)

机构地区：[1]广州医科大学,广东广州516000 [2]广州医科大学附属第三医院内分泌科,广东广州510145

出　　处：《西部医学》2020年第6期832-835,共4页Medical Journal of West China

基　　金：广东省自然科学基金(218811)。

摘　　要：目的探讨不同口服降糖药对2型糖尿病胰岛素泵强化治疗患者胰岛功能及预后的影响。方法选择2018年11月~2019年7月来我院治疗2型糖尿病患者的103例作为研究对象,用随机数字表法将其分为观察组52例和对照组51例,观察组采用胰岛素泵强化联合达格列净治疗,对照组采用胰岛素泵强化联合二甲双胍治疗。比较两组治疗前后血糖相关指标、临床相关指标、治疗后胰岛素用量、血糖完全达标人数、血糖达标时间、体重增加值。结果治疗后2个月,观察组空腹血糖(FBG)、平均餐后2h血糖(2hBG)、高血糖百分比、糖化血红蛋白(HbAlc)均明显低达对照组,且低血糖百分比明显高于对照组(P<0.05);观察组体重、血压、餐后2hC肽、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)及胰岛β细胞功能指数(HOMA-β)均明显低于对照组,且空腹C肽及胰岛素抵抗指数(HOMA-IR)均明显高于对照组(P<0.05);观察组治疗后胰岛素用量、血糖达标时间、体重增加值均明显低于对照组,同时血糖完全达标人数率高于对照组(95.00 vs 68.42)%(P<0.05)。结论二甲双胍和达格列净两种降糖药治疗2型糖尿病均有一定效果,但达格列净对降低血糖与临床相关指标效果更为显著,可在临床推广应用。Objective To explore the effect of different oral hypoglycemic drugs on islet function and prognosis in patients with type 2 diabetes mellitus treated by intensive insulin pump.Methods 103 patients with type 2 diabetes treated in our hospital from July 2016 to July 2019 were selected as research objects.They were divided into observation group(n=52)and control group(n=51)by random number table method.Blood glucose related indicators before and after treatment,clinical related indicators,post-treatment insulin dosage,the number of patients with blood glucose reaching the standard,the time of blood glucose reaching the standard,and the added value of body weight were compared between the two groups.Results 2 months after treatment,FBG,2hBG,percentage of hyperglycemia,and HbAlc in the observation group were significantly lower than those in the control group.The percentage of hypoglycemia in the observation group was significantly higher than that in the control group(P<0.05).Body weight,blood pressure,2hC peptide,TC,TG,in the observation group were significantly lower than those in the control group.The fasting c-peptide in the observation group were significantly higher than those in the control group(P<0.05).After treatment,insulin dosage,blood glucose standard time and added value of body weight in the observation group were significantly lower than those in the control group.The rate of blood glucose standard in the observation group was higher than that in the control group(94.23 vs 80.39)%(P<0.05).Conclusion Metformin and daglidene both have certain effects in the treatment of type 2 diabetes,but daglidene has more significant effects on reducing blood glucose related indicators and clinical related indicators,which is worthy of clinical promotion and application.

关 键 词：2型糖尿病 达格列净 二甲双胍 降糖 胰岛素泵强化 

分 类 号：R587.1[医药卫生—内分泌]