西格列汀联合地特胰岛素治疗老年2型糖尿病的疗效及安全性观察

目的:评价西格列汀联合地特胰岛素治疗老年2型糖尿病的疗效及安全性。方法:将88例口服降糖药控制不佳的老年2型糖尿病患者随机分成2组,观察组(西格列汀联合地特胰岛素组)和对照组(瑞格列奈联合地特胰岛素组)各44例;观察12周,比较治疗前后2组患者的空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)、空腹C肽(FC-P)、体重指数(BMI)、胰岛素用量及低血糖发生情况。结果:治疗后2组FPG、2hPG、 HbA1c均较治疗前显著降低(P<0.05),观察组FC-P较治疗前显著增高(P<0.05),BMI较治疗前略有下降,但无显著性差异(P>0.05),对照组FC-P及BMI较治疗前均无显著性差异(P>0.05);组间比较两组治疗后FPG、2hPG、 HbA1c无显著性差异(P>0.05),观察组FC-P较对照组显著增高(P<0.05),胰岛素用量显著减少(P<0.05),BMI显著下降(P<0.05)。观察组低血糖发生率较对照组显著降低(P<0.05)。结论:西格列汀联合地特胰岛素治疗老年2型糖尿病疗效确切,且可改善胰岛β细胞功能,安全性好。

Therapeutic efficacy and safety of sitagliptin combined with insulin detemir against type 2 diabetes in elderly patients

OBJECTIVE To the therapeutic efficacy and safety of sitagliptin combined with insulin detemir against type 2 diabetes in elderly patients. METHODS A total of 88 poorly controlled elderly patients with type 2 diabetes (T2DM) with oral antidiabetic drugs (OAD) were randomly divided into two groups to receive sitagliptin combined with insulin detemir (observation group) or repaglinide combined with insulin detemir (control group) for 12weeks. The fasting blood glucose (FPG), 2-hour postprandial (2hPG), glycated hemoglobin (HbA1c), fasting C-peptide (FC-P), body mass index (BMI), insulin dosage and incidence of hypoglycemia were compared between groups before versus after treatment. RESULTS FPG, 2hPG, HbA1c were significantly decreased among two groups after treatment (P<0.05). FC-P was significantly increased in observation group after treatment (P<0.05), while BMI was slightly decreased(P>0.05). FC-P and BMI in control groups had no significant changes (P>0.05). No significant difference was observed in FPG, 2hPG, HbA1c between groups after treatment (P>0.05). FC-P was significantly higher in observation group than in control group (P<0.05), insulin dosage and BMI were decreased significantly (P<0.05). The incidence of hypoglycemia was significantly lower in observation group than in control group (P<0.05). CONCLUSION Sitagliptin combined detemir has therapeutic efficacy and good security in elderly patients with type 2 diabetics, and can improve islet β-cell functions.