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目的:评价甘精胰岛素联合沙格列汀或格列美脲稳定2型糖尿病血糖水平的作用效果。方法:将我院2收治的228例2型糖尿病患者按照随机数字表法分为研究组和对照组,每组114人。研究组给予沙格列汀联合甘精胰岛素进行治疗,对照组给予格列美脲联合甘精胰岛素进行治疗。全部病例在治疗前4 d及治疗满16周时应用动态血糖监测仪实施72 h动态血糖监测。对比两组治疗前后血糖水平相关指标及血糖水平浮动相关指标的变化。结果:研究组治疗后体质指数显著低于对照组(P<0.05)。两组治疗后空腹血糖均比本组治疗前显著下降(P<0.05)。两组治疗后糖化血红蛋白均比本组治疗前显著下降(P<0.05)。两组治疗后胰岛素用量无显著差异。两组平均血糖水平治疗前后无显著差异(P>0.05)。研究组治疗后血糖标准差、日内血糖平均波动幅度、日内血糖波动次数、日间血糖平均绝对差改善幅度显著优于对照组。两组高血糖治疗后均比治疗前显著改善,改善幅度无显著差异(P>0.05)。两组低血糖曲线下面积治疗前后无显著差异(P>0.05)。结论:甘精胰岛素并用沙格列汀更能在显著控制2型糖尿病患者血糖的同时,还可使其血糖水平保持持久稳定,且不增加其低血糖的发生风险。
Objective: To evaluate the effects of insulin glargine combined with saxagliptin or glimepiride on type 2 diabetes mellitus. Methods: 228 patients with type 2 diabetes mellitus admitted to our hospital were divided into study group and control group according to random number table method, with 114 in each group. The study group was given saxagliptin in combination with insulin glargine and the control group with glimepiride and insulin glargine. All cases in the first 4 days of treatment and treatment of 16 weeks when the application of dynamic glucose monitoring device for 72 h dynamic glucose monitoring. Before and after treatment, the blood glucose level related indicators and the changes of blood glucose level related indicators were compared. Results: The body mass index of the study group after treatment was significantly lower than that of the control group (P <0.05). After treatment, fasting blood glucose in both groups was significantly lower than that before treatment (P <0.05). After treatment, HbA1c in both groups were significantly lower than those before treatment (P <0.05). There was no significant difference in insulin dosage between the two groups after treatment. There was no significant difference between the two groups in mean blood glucose level before and after treatment (P> 0.05). After treatment, the study group, the standard deviation of blood glucose, the average daily fluctuations in blood glucose, blood glucose fluctuations in the number of days, the mean absolute difference between the improvement of blood glucose was significantly better than the control group. Both groups were significantly improved after treatment than before treatment, no significant difference in improvement (P> 0.05). No significant difference was found between the two groups under the curve of hypoglycemia before and after treatment (P> 0.05). CONCLUSIONS: Glargine and saxagliptin can not only significantly control the blood glucose in type 2 diabetic patients, but also keep its blood glucose level stable without increasing the risk of hypoglycemia.