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二甲双胍联合格列美脲或达格列净对2型糖尿病患者胰岛功能及生活质量的影响

Effects of metformin combined with glimepiride or dapagliflozin on islet function and quality of life in patients with type 2 diabetes mellitus

    摘要
  • 摘要:
      目的   观察二甲双胍不同联合用药方案对2型糖尿病患者胰岛功能及生活质量的影响。
      方法  随机选取老年2型糖尿病患者122例作为研究对象，采用随机数字表法分为对照组和观察组，每组61例。对照组采用二甲双胍联合格列美脲治疗，观察组采用二甲双胍联合达格列净治疗。比较2组患者治疗前后血糖指标空腹血糖(FBG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbAlc)、空腹胰岛素(FINS)、胰岛功能指标胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)、胰岛素敏感指数(ISI)、血脂指标总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平和生活质量评分心理相关生存质量(MCS)评分、生理相关生存质量(PCS)评分。
      结果  治疗前, 2组患者血糖指标、胰岛功能指标、血脂指标水平以及生活质量评分比较，差异均无统计学意义(P>0.05); 治疗后, 2组患者FBG、2 hPG、HbAlc、FINS、TC、TG、LDL-C水平和HOMA-IR低于治疗前, HDL-C水平、HOMA-β、ISI和MCS评分、PCS评分高于治疗前，差异有统计学意义(P < 0.05); 治疗后，观察组FBG、2 hPG、HbAlc、FINS、TC、TG、LDL-C水平和HOMA-IR低于对照组, HDL-C水平、HOMA-β、ISI和MCS评分、PCS评分高于对照组，差异有统计学意义(P < 0.05)。
      结论   二甲双胍联合格列美脲或达格列净均能有效控制患者血糖水平，并改善患者血脂水平、胰岛功能。与二甲双胍联合格列美脲比较，二甲双胍联合达格列净的治疗效果更优，安全系数高，血糖控制效果更好，在调节血脂水平的同时还能避免低血糖发生，可显著提高患者的生活质量。

     

    Abstract:
      Objective  To observe the effects of metformin combined therapies on islet function and quality of life in patients with type 2 diabetes mellitus.
      Methods  A total of 122 elderly patients with type 2 diabetes were randomly selected and divided into control group and observation group by random number table method, with 61 cases in each group. The control group was treated with metformin combined with glimepiride. The observation group received metformin combined with dapagliflozin for treatment. Blood glucose indexesfasting blood glucose (FBG), 2 h postprandial blood glucose (2 hPG), glycated hemoglobin (HbAlc), fastening insulin (FINS), islet function indexes insulin resistance index (HOMA-IR), islet β-cell function index (HOMA-β), insulin sensitivity index (ISI), blood lipid indexes total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) level and quality of life score psychological related quality of life (MCS) score and physiological related quality of life (PCS) score were compared.
      Results  Before treatment, there were no significant differences in blood glucose indexes, islet function indexes, blood lipid level and quality of life score between two groups (P>0.05). After treatment, the levels of FBG, 2 hPG, HBALC, FINS, TC, TG, LDL-Cand HOMA-IR in two groups were significantly lower than before treatment, while the levels of HDL-C, HOMA-β, ISI, MCS and PCS were significantly higher than before treatment (P < 0.05). After treatment, the levels of FBG, 2 hPG, HBALC, FINS, TC, TG, LDL-C and HOMA-IR in the observation group were significantly lower than those in the control group, and the levels of HDL-C, HOMA-β, ISI, MCS and PCS scores were significantly higher than those in the control group (P < 0.05).
      Conclusion  Metformin combined with glimepiride or dapagliflozin can effectively control patients′ blood glucose levels, improve patients′ blood lipid levels and pancreatic islet function. Among them, metformin combined with dapagliflozin has a relatively better therapeutic effect and safety. Besides, it can regulate the blood glucose, avoid the occurrence of hypoglycemia and improve patients′ quality of life.

     

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