达格列净片治疗2型糖尿病血糖控制不佳患者的疗效与低血糖风险观察

目的 探讨达格列净治疗血糖控制效果不佳的2型糖尿病(T2DM)患者的疗效与安全性。 方法 选取丽水市中心医院2017年1月—2018年12月收治的96例血糖控制效果不佳的T2DM患者,采用简单随机分组分为观察组与对照组,各48例。对照组采用二甲双胍联合阿卡波糖治疗,观察组在对照组基础上联合达格列净片。不同时间点的FBG、2hPBG、HbA1c采用方差检验,2组患者体重、腰围、TC、TG、LDL-C、HDL-C、SBP与DBP、胰岛素日剂量采用t检验,HbA1c达标率与复合终点达标率、不良反应发生率采用χ2检验。 结果 整体比较:FBG、2hPBG、HbA1c的组间、时间点、分组与时间的交互作用有统计学意义(F=79.576,85.433,43.369,P<0.05)。固定分组因素时,2组FBG、2hPBG、HbA1c不同时间点的比较均有统计学意义(F=127.830,151.870,97.566,P<0.05);固定时间因素时,FBG、2hPBG、HbA1c的组间比较有统计学意义(F=45.652,61.546,21.006,P<0.05)。与治疗前比较,2组治疗4周、8周、16周的FBG、2hPBG、HbA1c均显著降低(P<0.05)。观察组和对照组HbA1c达标率为60.42%和56.25%,差异无统计学意义(χ2=0.171,P>0.05)。观察组复合终点达标率45.83%,高于对照组25.00%(χ2=4.554,P<0.05)。观察组低血糖发生率4.17%,低于对照组18.75%(χ2=5.031,P<0.05)。 结论 达格列净治疗血糖控制不佳的T2DM患者的降糖效果理想,可减少胰岛素用量,安全性高。 

Therapeutic effect of dapagliflozin on patients with type 2 diabetes with poor glycemic control and the risk of hypoglycemia

Objective To explore the efficacy and safety of dapagliflozin in patients with type 2 diabetes mellitus(T2 DM) with poor glycemic control. Methods Ninety-six T2 DM patients who had poor glycemic control were enrolled in our hospital from January 2017 to December 2018, and divided into observation group and control group by simple random, 48 cases in each. The control group was treated with metformin combined with acarbose, and the observation group treated with dapagliflozin on the basis of control group. The FBG, 2 hPBG, and HbA1 c at different points were tested by variance. The body weight, waist circumference, TC, TG, LDL-C, HDL-C, SBP and DBP, and the daily dose of insulin were tested by t test, while HbA1 c compliance rate, composite endpoint compliance rate, incidence of adverse reactions were tested by χ2 tests. Results Overall comparison: the interaction between FBG, 2 hPBG, HbA1 c, time point, grouping and time was statistically significant(F=79.576, 85.433, 43.369, all P<0.05). When the grouping factor is fixed, the comparison of FBG, 2 hPBG and HbA1 c at different time points is statistically significant(F=127.830, 151.870, 97.566, all P<0.05); when the time factor is fixed, the comparison of FBG, 2 hPBG and HbA1 c between groups It has statistical significance(F=45.652, 61.546, 21.006, all P<0.05). Compared with before treatment, the FBG, 2 hPBG and HbA1 c of the two groups at 4 weeks, 8 weeks and 16 weeks of treatment were significantly reduced(all P<0.05). The compliance rates of HbA1 c in the observation group and the control group were 60.42% and 56.25%, and the difference was not statistically significant(χ2=0.171, P>0.05). The composite endpoint compliance rate in the observation group was 45.83%, which was higher than the control group by 25.00%(χ2=4.554, P<0.05). The incidence of hypoglycemia in the observation group was 4.17%, which was lower than the control group by 18.75%(χ2=5.031, P<0.05). Conclusion Dapagliflozin is ideal for treating hypoglycemic T2 DM patients with hypoglycemic effect, can reduce the amount of insulin, and has high safety.