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选取接受足量二甲双胍治疗至少3个月且血糖不达标的超重或肥胖的2型糖尿病患者60例,给予联合沙格列汀治疗3个月,监测患者联合治疗前后体重、体重指数、腹围、血压变化及血糖、糖化血红蛋白、胰岛素及低密度脂蛋白胆固醇等生化指标的变化,并进行前后对照分析。结果联合治疗后,患者体重、体重指数、血压水平、糖化血红蛋白及低密度脂蛋白胆固醇较前下降,但无统计学差异(P>0.05);联合治疗后,患者空腹血糖、空腹胰岛素、早餐后2小时血糖及胰岛素水平较前下降,差异具有统计学意义(P<0.05);联合治疗期间无明确低血糖事件发生。结论二甲双胍联合沙格列汀治疗超重和肥胖2型糖尿病患者安全有效,而且对血压、血脂等代谢指标也有改善作用,糖化血红蛋白下降不显著考虑与随访时间不足有关。
Sixty patients with overweight or obese type 2 diabetes who were treated with metformin for at least 3 months and were not eligible for glycemic control were enrolled in this study. The patients were given combined saxagliptin for 3 months and the body weight, body mass index, abdominal circumference, Blood pressure and blood glucose, glycosylated hemoglobin, insulin and low density lipoprotein cholesterol and other biochemical indicators of change, and before and after the control analysis. Results After treatment, the body weight, body mass index, blood pressure, HbA1c and LDL cholesterol decreased compared with the previous group, but there was no significant difference (P> 0.05). After the combination therapy, the fasting blood glucose, fasting insulin, 2-hour blood glucose and insulin levels decreased compared with the previous, the difference was statistically significant (P <0.05); no clear hypoglycaemia occurred during the combination therapy. Conclusion Metformin combined with saxagliptin is safe and effective in the treatment of overweight and obese patients with type 2 diabetes mellitus, but also has an improved effect on blood pressure, blood lipid and other metabolic parameters. However, the decrease of glycosylated hemoglobin is not significantly related to the lack of follow-up time.