DPP-4抑制剂对二甲双胍+阿卡波糖治疗不佳的T2DM患者血糖控制和不良事件发生的影响  

The effect of DPP-4 inhibitors on blood glucose control and adverse events in T2DM patients with poor treatment with metformin+acarbose

作　　者：周娟 王俊 张强 Zhou Juan;Wang Jun;Zhang Qiang(Department of Endocrine Nephrology,Shangnan County Hospital,Shangluo,Shaanxi 726300,China)

机构地区：[1]陕西省商南县医院,陕西商洛726300

出　　处：《首都食品与医药》2024年第13期74-76,共3页Capital Food Medicine

摘　　要：目的分析二肽基肽酶4抑制剂(DPP-4抑制剂)对二甲双胍+阿卡波糖治疗不佳的2型糖尿病(T2DM)患者血糖控制和不良事件发生的影响。方法选择商南县医院2021年3月-2023年9月收治二甲双胍+阿卡波糖治疗不佳的T2DM患者(n=82),以随机数字表法分为对照组(n=41)和观察组(n=41)。两组均维持原二甲双胍+阿卡波糖治疗剂量不变,对照组联合吡格列酮,观察组联合DPP-4抑制剂(阿格列汀)。比较两组治疗前后的血糖、血脂、胰岛功能及不良事件发生情况。结果治疗后,观察组FPG、2hPG、HbA1c低于对照组(P<0.05);两组TC、TG均降低,且观察组低于对照组(P<0.05),两组HDL-C、LDL-C较治疗前无明显变化(P>0.05);两组HOMA-IR降低,FINS、HOMA-IR升高,且观察组优于对照组(P<0.05);观察组低血糖发生率低于对照组(P<0.05)。结论DPP-4抑制剂阿格列汀对二甲双胍+阿卡波糖治疗不佳的T2DM患者能够有效加强其血糖控制效果,改善血脂和胰岛功能,降低低血糖发生率。Objective To analyze the effect of dipeptidyl peptidase 4 inhibitor(DPP-4 inhibitor)on blood glucose control and adverse events in type 2 diabetes patients who were poorly treated with metformin and acarbose.Method T2DM patients(n=82)who received poor treatment with metformin and acarbose in our hospital from March 2021 to September 2023 were randomly divided into a control group(n=41)and an observation group(n=41)using a random number table method.Both groups maintained the original treatment dose of metformin+acarbose unchanged,while the control group combined with pioglitazone and the observation group combined with DPP-4 inhibitor(agliptin).Compare the blood glucose,blood lipids,pancreatic function,and incidence of adverse events between two groups before and after treatment.Result After treatment,the FPG,2hPG,and HbA1c in the observation group were lower than those in the control group(P<0.05);TC and TG were decreased in both groups,and the observation group was lower than the control group(P<0.05).HDL-C and LDL-C in both groups had no significant changes compared with before treatment(P<0.05).The HOMA-IR decreased in both groups,while FINS and HOMA-IR increased,and the observation group was better than the control group(P<0.05);the incidence of hypoglycemia in the observation group was lower than that in the control group(P<0.05).Conclusion DPP-4 inhibitor agliptin can effectively enhance blood glucose control,improve blood lipids and pancreatic function,and reduce the incidence of hypoglycemia in T2DM patients who are not well treated with metformin+acarbose.

关 键 词：二肽基肽酶4抑制剂 二甲双胍 阿卡波糖 2型糖尿病 血糖控制 不良事件 

分 类 号：R587.1[医药卫生—内分泌]