达格列净联合胰岛素强化治疗老年初诊2型糖尿病患者疗效观察  

Effect of Dagliazine after Intensive Insulin Therapy on Newly Diagnosed Type 2 Diabetes Mellitus in Elderly Patients

作　　者：张莹莹 张莉[2] ZHANG Yingying;ZHANG Li(Nursing College Chuzhou City Vocational College)

机构地区：[1]滁州城市职业学院护理学院,安徽滁州239000 [2]安徽中医药大学第一附属医院西园区

出　　处：《长治医学院学报》2023年第6期408-412,共5页Journal of Changzhi Medical College

基　　金：2022年高校优秀青年人才支持一般项目(gxyq2022234);职业教育提质培优行动计划项目(2021tgspzyq01);2020年安徽省质量工程(2020zyq58);2020年安徽省高等学校省级质量工程(2020szsfkc0657)。

摘　　要：目的:观察胰岛素强化治疗后应用达格列净对老年初诊2型糖尿病患者的疗效。方法:选择150例老年初诊2型糖尿病患者作为研究对象,按照随机数字法将其分为对照组和观察组,各75例。其中对照组给予胰岛素强化治疗,观察组在对照组治疗基础上加用达格列净治疗。比较2组患者临床相关指标变化、治疗前后血糖水平及胰岛功能差异,以及血清肿瘤坏死因子(TNF-α)、白细胞介素6(IL-6)、C反应蛋白(CRP)、血清超氧化物歧化酶(SOD)、丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-PX)水平变化,比较2组不良反应发生情况。结果:观察组患者初次达标时胰岛素用量、血糖达标时间均明显低于对照组(P<0.05);与治疗前相比,2组患者胰岛素抵抗指数(HOMA-IR)值明显降低,胰岛β细胞功能指标(HOMA-β)及空腹血胰岛素(FINS)、空腹C肽水平明显升高,且观察组改善更为显著(P<0.05);与治疗前相比,2组患者血清糖化血红蛋白(HbA1c)、2hPG、空腹血糖(FPG)、MDA、TNF-α、CRP及IL-6水平明显降低,血清SOD、GSH-PX水平明显升高,且观察组改善更为显著(P<0.05);2组患者不良反应发生率差异无统计学意义(P>0.05)。结论:达格列净联合胰岛素强化治疗老年初诊T2DM患者,可控制血糖水平,改善胰岛细胞功能,减轻炎症反应和应激反应,安全有效。Objective:To explore the effect of dagliazine after intensive insulin therapy on newly diagnosed type 2 diabetes in the elderly and its effects on islet function and inflammatory factors,so as to provide a reference for clinical diagnosis and treatment.Methods:A total of 150 elderly patients with newly diagnosed type 2 diabetes were randomly divided into the control group and the observation group,with 75 cases in each group.The control group was given insulin-intensive treatment,and the observation group was treated with dagliazine based on the above treatment.The changes in clinical indicators,blood glucose level,and islet function before and after treatment were compared between the two groups.The levels of serum tumor necrosis factor(TNF-α),Interleukin 6(IL-6),C-reactive protein(CRP),serum Superoxide dismutase(SOD),malondialdehyde(MDA),Glutathione peroxidase(GSH-Px)before and after treatment and the occurrence of adverse reactions of the 2 groups were compared.Results:The dosage of insulin and the time of blood glucose in the observation group were significantly lower than those in the control group(P<0.05).Compared with before treatment,the HOMA-IR value was significantly decreased,HOMA-β,FINS,and fasting C-peptide levels were significantly increased in the two groups,and the above indexes improved more significantly in the observation group after treatment(P<0.05).Compared with before treatment,serum levels of HbA1c,2hPG,FPG,MDA,TNF-α,CRP,and IL-6 in 2 groups were significantly decreased,while serum levels of SOD and GSH-PX were significantly increased,and the above indexes were improved more significantly in observation group after treatment(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Dagliazine combined with insulin in intensive treatment of elderly patients with newly diagnosed T2DM can control blood glucose levels,improve the function of islet cells,reduce inflammation and stress response,and is safe and effective,worthy

关 键 词：胰岛素强化 达格列净 2型糖尿病 胰岛功能 炎症因子 

分 类 号：R587[医药卫生—内分泌]