大剂量胰岛素联合西格列汀对老年2 型糖尿病患者的疗效

目的:研究大剂量胰岛素联合西格列汀对老年2型糖尿病患者的疗效。方法:选择2012年1月~2015年12月在我院进行诊治的老年2型糖尿病患者82例,随机分为两组,观察组采用大剂量胰岛素联合西格列汀治疗,对照组采用大剂量胰岛素治疗,两组均治疗3个月。比较两组治疗前后的甘油三酯、总胆固醇、低密度脂蛋白和高密度脂蛋白水平,餐后2 h血糖、空腹血糖、糖化血红蛋白,胰岛素抵抗指数、胰岛素分泌指数、每日胰岛素总量和低血糖发生次数。结果:对照组治疗前后的血脂水平无明显差异(P0.05),观察组治疗后的甘油三酯、总胆固醇和低密度脂蛋白明显降低(P0.05),高密度脂蛋白明显升高(P0.05);治疗后,两组的餐后2 h血糖、空腹血糖、糖化血红蛋白均明显降低(P0.05),且观察组降低更为明显(P0.05);对照组治疗前后的胰岛素抵抗指数、胰岛素分泌指数和每日胰岛素总量均无明显差异(P0.05),观察组治疗后的胰岛素抵抗指数和每日胰岛素总量均明显降低(P0.05),胰岛素分泌指数明显升高(P0.05);两组治疗前后低血糖发生次数和身体质量指数均无明显差异(P0.05)。结论:大剂量胰岛素联合西格列汀能有效控制老年2型糖尿病患者的血糖水平,改善胰岛β细胞功能,减少胰岛素用量,是一种安全有效的治疗方法。

Effects of High-dose Insulin Combined with Sitagliptin on Elderly Patients with Type 2 Diabetes Mellitus

Objective:To study the effects of high-dose insulin combined with sitagliptin on elderly patients with type 2 diabetes mellitus.Methods:82 cases of elderly patients with type 2 diabetes mellituswho were treated in our hospital from January 2012 to December 2015 were selected and divided into two groups randomly, the patients in observation group were treated with high-dose insulin combined with sitagliptin, and the patients in control group were treated with high-dose insulin. The triglyceride, total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol levels, postprandial 2 h blood glucose, fasting glucose, glycosylated hemoglobin, insulin resistance, insulin secretion index, total daily insulin, and the frequency of hypoglycaemia of the two groups were compared.Results:The lipid level before and after treatment had no significant difference between the two groups (P>0.05), after treatment, the triglyceride, total cholesterol and low density lipoprotein of observation group was decreased significantly (P<0.05), the level of high-density lipoprotein cholesterol was increased significantly (P<0.05); the postprandial 2 h blood glucose, fasting glucose, glycosylated hemoglobin of two groups were significantly lower (P<0.05), and it was more significantly in observation group (P<0.05); the insulin resistance, insulin secretion index and total daily insulin had no significant difference between the two groups(P>0.05), the insulin resistance index and total daily insulin of observation group was decreased significantly (P<0.05), the insulin secretion index was increased significantly (P<0.05); the frequency of hypoglycaemia and body mass index had no significant difference between two groups before and after treatment (P>0.05).Conclusion:High-dose insulin combined with sitagliptin can effectively control the blood glucose level of elderly patients with type 2 diabetes mellitus, improve islet beta-cell function, and reduce the dosage of insulin, which is safe and effective.