达格列净治疗2型糖尿病的临床研究

  目的   观察达格列净联合预混胰岛素治疗血糖控制较差的2型糖尿病患者的临床疗效、安全性及耐受性。   方法   选择2019年1月—2020年3月期间于淮北市人民医院住院的60例注射门冬胰岛素30与二甲双胍口服联合治疗血糖控制不达标的2型糖尿病患者, 根据临床治疗方法分为2组，每组30例, 对照组使用门冬胰岛素30注射联合二甲双胍口服，观察组在对照组基础上加服达格列净片，2组患者在治疗期间监测血糖，根据血糖水平调整胰岛素剂量, 比较2组患者空腹血糖、餐后2小时血糖、糖化血红蛋白、血糖达标时间、胰岛素用量、低血糖事件、体重变化及患者出现的不良反应情况。   结果   治疗12周后，对照组与观察组的空腹血糖、餐后2小时血糖、糖化血红蛋白均低于治疗前(P < 0.05)，观察组的空腹血糖(6.60±0.52)mmol/L、血糖达标时间(6.67±1.60)d、胰岛素用量(40.17±7.01)U/d、体重指数23.41±2.11均低于对照组，差异有统计学意义(P < 0.05)。观察组2例患者出现低血糖，对照组有8例患者出现低血糖，对照组患者的低血糖发生率高于观察组，差异有统计学意义(P < 0.05)。   结论   在2型糖尿病患者中应用达格列净联合预混胰岛素降糖效果显著, 具有减轻体重优势，患者安全性和耐受性好。 

Clinical efficacy of dapagliflozin in the treatment of type 2 diabetes mellitus

  Objective  To observe the clinical therapeutic effect, safety and tolerance of dapagliflozin combined with premix insulin in treatment for type 2 diabetes mellitus with poor glucose control.   Methods   Total 60 patients with type 2 diabetes mellitus with poor glycemic control treated with oral insulin aspartate 30 and metformin were treated in Huaibei People's Hospital from January 2019 to March 2020 were divided into 2 groups, 30 cases in each group according to the clinical treatment. The observation group received the treatment of dapagliflozin combined with insulin aspart 30 and metformin, and the control group was only treated with insulin aspart 30 and metformin. Two groups of the patients adjust insulin dose according to the level of plasma glucose. The patient's fasting plasma glucose (FPG), 2-hour postprandial blood glucose (2hPG), hemoglobin A1c (HbA1c), plasma glucose controlling time, insulin doses, presence of hypoglycemic events, weight change and adverse reaction were recorded.   Results   After 12 weeks of treatment, the fasting plasma glucose, 2-hour postprandial blood glucose and hemoglobin A1c in the two groups were lower than before treatment (P < 0.05). Fasting plasma glucose (6.60±0.52) mmol/L, plasma glucose controlling time (6.67±1.60) d, insulin dosage (40.17±7.01) U/d and body mass index (23.41±2.11) in the observation group were lower than the control group (P < 0.05). Two patients in the observation group had hypoglycemia, while eight patients in the control group had hypoglycemia. The incidence of hypoglycemia in the control group was higher than that in the observation group. There was statistical difference between the two groups (P < 0.05).   Conclusion   The clinical efficacy of dapagliflozin combined with premix insulin is significant in the treatment of type 2 diabetes. It has the advantages of weight loss, good safety and tolerance.