摘要
目的研究接受胰岛素治疗效果欠佳的2型糖尿病(type 2 diabetes mellitus,T2DM)患者短期内联用达格列净片后的血糖波动及安全性。方法纳入2018年3月至2019年12月于徐州医科大学附属医院内分泌科就诊的、接受四针胰岛素联合二甲双胍缓释片后血糖仍未较好改善的T2DM患者100例为研究对象,随机分为5 mg组和10 mg组,每组50例。两组均在胰岛素治疗基础上加用达格列净片口服,剂量分别为每次5 mg和10 mg,一日1次,疗程均为1周。比较两组患者治疗前、后空腹血糖(fasting plasma glucose,FPG)及餐后2 h血糖(2 h postprandial blood glucose,2hPG)变化,以及两组治疗前、后及治疗后组间相应血糖波动情况,如最大血糖波动幅度(maximum fluctuation range of blood glucose,LAGE)、日内血糖标准差(standard deviation of intra day blood glucose,SDBG)、平均血糖值(mean blood glucose,MBG)、餐后血糖平均波动幅度(average fluctuation range of postprandial blood glucose,PPGE)、日内血糖平均波动幅度(average fluctuation range of blood glucose within a day,MAGE)、日间血糖平均绝对差(mean absolute difference in daytime blood glucose,MODD)及血糖变异系数(coefficient of variation of blood glucose,CV)等,同时记录患者不良事件发生情况。结果两组患者FPG及2hPG均较治疗前下降(P<0.05),且10 mg组FPG及2hPG低于5 mg组(P<0.05)。治疗后,两组LAGE、SDBG、MAGE、PPGE、MODD、MBG及CV较治疗前均改善(P<0.05),且10 mg组上述指标低于5 mg组(P<0.05)。两组患者均未发生严重低血糖事件。结论短期内应用达格列净联合胰岛素可快速且稳定地降糖、改善血糖波动,且低血糖等不良反应较少。
Objective To study the blood glucose fluctuation and safety of type 2 diabetes mellitus (T2DM) patients with poor insulin treatment after short-term combined use of dapagliflozin tablets.Methods From March 2018 to December 2019,a total of 100 patients who received four-injection insulin combined with metformin sustained release tablets but without good treatment effect were enrolled in the Endocrine Department,the Affiliated Hospital of Xuzhou Medical University,then they were randomly allocated into 5 mg group and 10 mg group,50 cases in each group.On the basis of insulin treatment,5 mg and 10 mg dapagliflozin tablets were added orally each day into treatment for patients in both groups respectively,the course of treatment was 1 week.The fasting plasma glucose(FPG) and 2 h postprandial blood glucose(2hPG) of the two groups were compared before and after treatment,as well as blood glucose fluctuation parameters,such as maximum fluctuation range of blood glucose(LAGE),standard deviation of intra day blood glucose(SDBG),mean blood glucose(MBG),average fluctuation range of postprandial blood glucose(PPGE),average fluctuation range of blood glucose within a day(MAGE),mean absolute difference in daytime blood glucose(MODD) and coefficient of variation of blood glucose(CV).Meanwhile,the occurrence of adverse events was recorded.Results FPG and 2hPG of the two groups were lower than those before treatment(P<0.05),and FPG and 2hPG in 10 mg group were lower than those in 5 mg group(P<0.05).After treatment,LAGE,SDBG,MAGE,PPGE,MODD,MBG and CV of the two groups were improved(P<0.05),and the above indexes of 10 mg group were lower than that of 5 mg group(P<0.05).There was no serious hypoglycemia occurred in both groups.Conclusion In short-term treatment,the application of dapagliflozin combined with insulin can rapidly and stably reduce blood glucose and improve blood glucose fluctuation,the hypoglycemia and other adverse reactions are less.
作者
李萌曦
孟凡东
李伟
LI Meng-xi;MENG Fan-dong;LI Wei(Graduate School of Xuzhou Medical University,Xuzhou 221000,Jiangsu Province,China;Department of Endocrinology,the Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,Jiangsu Province,China)
出处
《世界临床药物》
CAS
2020年第11期880-885,890,共7页
World Clinical Drug
基金
徐州市科技计划项目基金资助(KC17157)。
关键词
达格列净
短期治疗
血糖波动
2型糖尿病
dapagliflozin
short-term treatment
blood glucose fluctuation
type 2 diabetes mellitus
