T2DM糖代谢控制中二甲双胍、达格列净与强化胰岛素联合治疗的应用效果  

Effect of Combination Therapy with Metformin,Dapagliflozin and Inten⁃sive Insulin in Glucose Metabolism Control of T2DM

作　　者：张立超 赵静[1] 任艳飞 ZHANG Lichao;ZHAO Jing;REN Yanfei(Department of Endocrinology,Chifeng Hospital,Chifeng 024000,Inner Mongolia Autonomous Region,China)

机构地区：[1]赤峰市医院内分泌科,内蒙古赤峰024000

出　　处：《糖尿病新世界》2024年第11期121-124,共4页Diabetes New World

摘　　要：目的探究二甲双胍、达格列净与强化胰岛素联合治疗2型糖尿病(type 2 diabetes mellitus,T2DM)对糖代谢控制效果的影响。方法选取2022年1月—2024年1月赤峰市医院内分泌科收治的120例T2DM患者为研究对象,按照治疗方法不同分为对照组(二甲双胍与强化胰岛素联合治疗)与研究组(对照组基础上加入达格列净治疗),各60例。对比两组糖代谢控制情况(餐后2 h血糖、空腹血糖、糖化血红蛋白)、胰岛素分泌相关指标(空腹胰岛素、胰岛β细胞功能指数、胰岛素抵抗指数)、临床疗效、血糖目标范围时间(time in range,TIR)。结果治疗前,两组糖代谢水平及胰岛素分泌相关指标比较,差异无统计学意义(P均>0.05);治疗90 d后,研究组糖代谢水平、胰岛素分泌相关指标改善情况均优于对照组,差异有统计学意义(P均<0.05)。研究组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。研究组TIR高于对照组,差异有统计学意义(P<0.05)。结论T2DM糖代谢控制中二甲双胍与强化胰岛素联合治疗基础上加入达格列净,糖代谢水平控制更佳且疗效显著,胰岛素分泌情况调节效果更佳且血糖目标范围时间可保持在更佳水平。Objective To explore the effect of metformin,dapagliflozin and intensive insulin on the control of glucose metabolism in type 2 diabetes mellitus(T2DM).Methods A total of 120 patients with T2DM admitted to the Depart-ment of Endocrinology of Chifeng Hospital from January 2022 to January 2024 were selected as the research objects.According to different treatment methods,they were divided into control group(metformin combined with intensive in-sulin therapy)and study group(dapagliflozin treatment was added on the basis of the control group),with 60 cases in each group.The glucose metabolism control(2-hour postprandial blood glucose,fasting blood glucose,glycated hemo-globin A1c),insulin secretion related indicators(fasting insulin,isletβcell function index,insulin resistance index),clinical efficacy,time in range(TIR)of blood glucose target range were compared between the two groups.Results Be-fore treatment,there was no significant difference in the levels of glucose metabolism and insulin secretion related in-dicators between the two groups(all P>0.05).After 90 days of treatment,the improvement of glucose metabolism and insulin secretion related indexes in the study group was better than that in the control group,and the differences were statistically significant(all P<0.05).The total effective rate of treatment in the study group was higher than that in the control group,the difference was statistically significant(P<0.05).The TIR in the study group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion In the control of T2DM glucose metabolism,dapagliflozin was added on the basis of the combination of metformin and intensive insulin.The level of glucose metabolism was better controlled and the curative effect was significant.The regulation effect of insulin secretion was better and the time of blood glucose target range could be maintained at a better level.

关 键 词：2型糖尿病 胰岛素 二甲双胍 达格列净 糖代谢 临床疗效 

分 类 号：R587.1[医药卫生—内分泌]