格列美脲与沙格列汀联合治疗对2型糖尿病患者血糖控制、胰岛素抵抗及血脂的影响

目的:探讨2型糖尿病(T2DM)患者经格列美脲联合沙格列汀治疗后的临床效果,并分析其对患者血糖控制、胰岛素抵抗及血脂的影响。方法:选取我院2017年4月~2019年4月期间接收的88例T2DM患者,按乱数表法将患者分为研究组(n=44,格列美脲联合沙格列汀治疗)、对照组(n=44,沙格列汀治疗)。比较两组患者临床疗效、血糖、胰岛素抵抗及血脂指标,记录两组患者不良反应情况。结果:研究组治疗3个月后临床总有效率较对照组升高(P<0.05)。两组患者治疗3个月后空腹血糖(FBG)、餐后两小时血糖(2hPBG)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)、总胆固醇(TC)、低密度脂蛋白(LDL-C)、甘油三酯(TG)均下降,且研究组低于对照组(P<0.05)。两组患者治疗3个月后高密度脂蛋白(HDL-C)、空腹胰岛素(FINS)升高,且研究组高于对照组(P<0.05)。两组不良反应总发生率比较无差异(P>0.05)。结论:T2DM患者采用格列美脲联合沙格列汀治疗效果确切,可改善机体血脂水平及胰岛素抵抗,控制血糖水平,且用药安全性较好。

The Effect of Glimepiride Combined with Saxagliptin on Blood Glucose Control, Insulin Resistance and Blood Lipid in Patients with Type 2 Diabetes Mellitus

ABSTRACT Objective: To explore the clinical effect of glimepiride combined with saxagliptin in type 2 diabetes mellitus (T2DM), and analyze its effect on blood glucose control, insulin resistance and blood lipid. Methods: 88 patients with T2DM received by our hospital from April 2017 to April 2019 were selected, they were randomly divided into study group (n=44, glimepiride combined with saxagliptin treatment) and control group (n=44, saxagliptin treatment ). The clinical efficacy, blood glucose, insulin resistance and blood lipid indexes of the two groups were compared, and the adverse reactions of the two groups were recorded. Results: The total clinical effective rate of the study group was higher than that of the control group (P<0.05). The fasting blood glucose (FBG), 2 hour postprandial blood glucose (2hPBG), glycosylated hemoglobin (HbA1c), insulin resistance index (HOMA-IR), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and triglyceride (TG) of the two groups all decreased at 3 months after treatment, and those in the study group were lower than those in the control group (P<0.05). 3 months after treatment, the levels of high density lipoprotein cholesterol (HDL-C) and fasting insulin (FINS) in the two groups were increased, and those in the study group were higher than those in the control group (P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P>0.05). Conclusion: Glimepiride combined with saxagliptin is effective in the treatment of patients with T2DM, which can improve the body''s blood lipid level and insulin resistance, control the blood glucose level, and the drug safety is better.