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目的:观察磷酸西格列汀片联合地特胰岛素治疗2型糖尿病的效果。方法:选择病程5年以下、口服降糖药物效果欠佳的2型糖尿病100例,随机分为观察组和对照组各50例。对照组采用诺和灵30R皮下注射联合磷酸西格列汀早餐前口服;观察组采用地特胰岛素皮下注射联合磷酸西格列汀早餐前口服。共治疗12周,期间根据患者血糖水平并参照《中国糖尿病防治指南》调整胰岛素剂量。比较两组空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)水平及胰岛素用量;疗程结束后第3天进行动态血糖监测(CGMS),观察两组血糖波动情况、低血糖发生情况等。结果:治疗后,两组FPG、2hPG、HbA1c水平均较治疗前显著或非常显著降低(P<0.05,P<0.01),观察组2hPG水平显著低于对照组治疗后(P<0.05)。疗程结束时,观察组胰岛素用量非常显著少于对照组(P<0.01)。CGMS检查结果显示,观察组FPG水平、高血糖时间比、低血糖时间比、血糖波动系数均显著或非常显著低于对照组(P<0.05,P<0.01)。结论:磷酸西格列汀联合地特胰岛素治疗病程不足5年的2型糖尿病,可有效控制血糖水平,减少血糖波动,发生低血糖的风险降低,安全性更好。
Objective: To observe the effect of sitagliptin phosphate tablet and insulin dextrose treatment of type 2 diabetes mellitus. Methods: A total of 100 cases of type 2 diabetes mellitus with less than 5 years of duration of oral hypoglycemic drugs were randomly divided into observation group (50 cases) and control group (50 cases). The control group was treated with Novolin 30R subcutaneous injection combined with sitagliptin phosphate before breakfast; the observation group was treated with insulin dextrose subcutaneous injection combined with sitagliptin phosphate before breakfast. A total of 12 weeks of treatment, during which based on the patient’s blood glucose level and with reference to “Guidelines for the Prevention and Treatment of Diabetes in China” to adjust the insulin dose. Fasting blood glucose (FPG), postprandial 2h glucose (HbA1c), and insulin dosage were compared between the two groups. On the third day after the treatment, dynamic blood glucose monitoring (CGMS) was performed. Blood glucose fluctuation, hypoglycemia Occurrences and so on. Results: After treatment, the levels of FPG, 2hPG and HbA1c in both groups were significantly or very significantly lower than those before treatment (P <0.05, P <0.01). The levels of 2hPG in the observation group were significantly lower than those in the control group after treatment (P <0.05). At the end of treatment, the amount of insulin used in the observation group was significantly less than that of the control group (P <0.01). The results of CGMS showed that the levels of FPG, hyperglycemic time, hypoglycemic time, and blood glucose fluctuation were all significantly or significantly lower in the observation group than those in the control group (P <0.05, P <0.01). Conclusion: Sitagliptin phosphate combined with insulin detemir treatment of type 2 diabetes less than 5 years course can effectively control blood sugar levels, reduce blood sugar fluctuations, reduce the risk of hypoglycemia, better security.