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目的:评价西格列汀联合胰岛素强化治疗初诊2型糖尿病的临床疗效。方法:初诊2型糖尿病患者120例随机分成两组,A组予胰岛素强化治疗,B组在A组基础上加用西格列汀片100 mg,po qd。治疗12周后比较两组患者的血糖、血脂各项指标及药品不良反应。结果:治疗后,两组患者的空腹血糖(FPG)、餐后2 h血糖(2h FPG)、糖化血红蛋白(Hb A1c)、总胆固醇(TG)、低密度脂蛋白(LDL)等指标均较治疗前显著下降(P<0.05),高密度脂蛋白(HDL)较治疗前明显升高(P<0.05),且B组FPG、2h FPG、Hb A1c、TG比A组下降更明显(P<0.05)。两组患者胰岛β细胞功能、稳态模型胰岛素抵抗指数(HOMA-IR)均较前明显改善(P<0.05),且B组胰岛β细胞功能的改善优于A组(P<0.05)。治疗过程中B组低血糖频率显著低于A组(P<0.05)。结论:西格列汀联合胰岛素强化治疗可有效控制初诊2型糖尿病患者的血糖,显著减少低血糖事件的发生,改善患者的胰岛β细胞功能,并具有一定的降血脂作用。
OBJECTIVE: To evaluate the clinical efficacy of sitagliptin plus insulin in the treatment of newly diagnosed type 2 diabetes. Methods: 120 newly diagnosed type 2 diabetic patients were randomly divided into two groups. Group A received intensive insulin treatment. Group B received sitagliptin 100 mg, po qd on the basis of group A. After 12 weeks of treatment, the two groups of patients were compared with blood glucose, blood lipid indicators and adverse drug reactions. Results: After treatment, the fasting blood glucose (FPG), postprandial 2h FPG, Hb A1c, total cholesterol (LDL) and total cholesterol (LDL) (P <0.05). The levels of HDL in HDL group were significantly lower than those in group A (P <0.05), and the levels of FPG, 2h FPG, Hb A1c and TG in group B were significantly lower than those in group A (P <0.05) ). The function of islet β cells and homeostasis model insulin resistance index (HOMA-IR) in both groups were significantly improved (P <0.05), and the function of β cells in group B was better than that in group A (P <0.05). During treatment, the frequency of hypoglycemia in group B was significantly lower than that in group A (P <0.05). Conclusion: The combination of sitagliptin and insulin therapy can effectively control the blood glucose in newly diagnosed type 2 diabetic patients, significantly reduce the incidence of hypoglycemic events, improve the function of pancreatic β-cells and have some hypolipidemic effects.