西格列汀联合大剂量胰岛素治疗2型糖尿病的临床观察

doi:10.6040/j.issn.1671-7554.0.2014.747

摘要/Abstract

摘要： 目的观察大剂量胰岛素联合西格列汀治疗2型糖尿病的临床疗效和安全性.方法选取2012年9月至2013年9月确诊2型糖尿病并需大剂量胰岛素(>60 U/d)治疗的患者60例,随机分为两组:胰岛素+西格列汀组(胰岛素>60 U/d,西格列汀100 mg,1次/d)和胰岛素组(胰岛素>60 U/d),每组30例.治疗3个月,根据血糖情况调整剂量.比较治疗前及治疗3个月后血糖、血脂等指标的变化及两组间主要指标的变化情况.结果治疗3个月后,两组空腹血糖(FBG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)较治疗前有所下降(P均<0.05),胰岛素组胰岛素用量及体质量指数(BMI)较治疗前显著增加(P<0.05),胰岛素+西格列汀组治疗后胰岛素用量减少,BMI、甘油三酯(TG)降低(P<0.05).胰岛素组与胰岛素+西格列汀组胰岛素用量[(70.32±6.56) vs (59.26±5.03)U]、TG[(2.64±1.32) vs (2.21±0.92)mmol/L]、BMI(27.24±2.36 vs 26.25±1.92)差异具有统计学意义(P均<0.01).胰岛素组与胰岛素+西格列汀组分别有8例(26.70%)和1例(3.30%)患者出现低血糖.结论大剂量胰岛素(>60 U/d)联合西格列汀(100 mg,1次/d)治疗2型糖尿病有利于患者血糖、血脂、BMI的控制,同时可以减少胰岛素用量,降低低血糖发生率.

关键词: 西格列汀, 低血糖, 2型糖尿病, 大剂量胰岛素

Abstract: Objective To observe the efficacy and safety of sitagliptin combined with high-dose insulin on type 2 diabetes mellitus. Methods Sixty patients with type 2 diabetes who needed high-dose insulin(greater than 60 U/d) treatment, diagnosed during Sep. 2012 to Sep. 2013 in our hospital, were divided into insulin combined with sitagliptin group(insulin>60 U/d and sitagliptin 100 mg 1 time/d) and insulin group (insulin>60 U/d ), with 30 patients in each group. After 3-month treatment, the levels of blood glucose, serum lipid and other indicators were compared between the two groups. Results After 3-month treatment, fasting blood glucose(FBG), 2-hour postprandial glucose (2hPG), glycosylated hemoglobin(HbA1c) decreased significantly (all P<0.05) in both group. The insulin dosage, body mass index (BMI) increased significantly (P<0.05) after treatment in insulin group, while the insulin dosage, BMI and triglyceride(TG)reduced significantly (P<0.05) after treatment in insulin combined with sitagliptin group. Compared with insulin group, the patients in insulin combined with sitagliptin group showed lower insulin dosage[(70.32±6.56) vs (59.26±5.03)U], TG[(2.64±1.32) vs (2.21±0.92) mmol/L] and BMI (27.24±2.36 vs 26.25±1.92)(all P<0.01). One patient(3.30%)in insulin combined with sitagliptin group and 8 patients (26.70%) in insulin group occurred hypoglycemia. Conclusion Sitagliptin(100 mg, 1 time/d) combined with high-dose(>60 U/d)insulin in the therapy of patients with type 2 diabetes mellitus is beneficial for controlling the indicators, such as blood glucose, serum lipid, BMI as well as reducing the dosage of insulin and occurrence of hypoglycemia.

Key words: Type 2 diabetes mellitus, High-dose insulin, Low blood glucose, Sitagliptin

中图分类号:

R587.1

裴蕾蕾, 孙中华, 李哲, 赵文萍. 西格列汀联合大剂量胰岛素治疗2型糖尿病的临床观察[J]. 山东大学学报（医学版）, 2015, 53(2): 39-42.

PEI Leilei, SUN Zhonghua, LI Zhe, ZHAO Wenping. Effects of sitagliptin combined with high-dose insulin on type 2 diabetes mellitus[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(2): 39-42.

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