Effects of empagliflozin combined with metformin in the treatment of elderly patients with type 2 diabetes mellitus and its in-fluence on bone metabolism and incidence of clinical endpoint events
Objective To investigate the effects of empagliflozin combined with metformin in the treatment of elderly patients with type 2 diabetes mellitus(T2DM)and its influence on bone metabolism and incidence of clinical endpoint events.Methods The clinical data of 360 elderly T2MD patients treated in People's Hospital of Guang'an City from January 2020 to December 2021 were retrospectively analyzed.According to different treatment methods,they were divided into observation group and control group,with 180 cases in each group.The observation group was treated with empagliflozin combined with metformin,and the control group was treated with metformin.The changes of blood glucose,homeostatic model assessment of insulin resistance index(HOMA-IR),islet beta cell function index(HOMA-β),body mass index(BMI),waist-to-hip ratio,blood pressure,left ventricular ejection fraction(LVEF),bone metabolism and bone mineral density were compared between the two groups before and after treatment.The patients were followed for at least 1.5 years,and the incidence of clinical end-point events in both groups was recorded.Results After treatment,the fasting plasma glucose(FPG),2 h postprandial blood glucose(2 hPG),glycosylated hemoglobin A1c(HbAlc)and HOMA-IR of the observation group were lower than those of the control group(P＜0.05),while HOMA-β was higher than that of the control group(P＜0.05);BMI,waist-to-hip ratio and systolic blood pressure(SBP)of the observation group were lower than those of the control group(P＜0.05),and LVEF was higher than that of the control group(P＜0.05).There was no statistical significance in PⅠNP,β-CTX and bone mineral density of lumbar L1-4 between the two groups(P＞0.05).The incidence of urinary ketone body positive in the observation group was higher than that in the control group(10.56% vs 1.11% ),while the incidence of complex nonfatal cardiovascular disease was lower than that in the control group(13.33% vs21.67% ),with statistical significance(P＜0.05).Conclusion On the basis of metformin,the addition of empagliflozin in the treatment of elderly T2MD patients can improve blood glucose lev-els and islet function,reduce body weight,lower blood pressure and cardiac load,and reduce the incidence of clinical endpoint events.It has no significant effect on bone mineral density in a short time.In addition,it is necessary to pay closely attention to the occurrence of adverse reactions and timely take symptomatic treatment during treatment.
elderlytype 2 diabetes mellitusempagliflozinmetforminblood glucose levelcardiac function
国家科技期刊平台
NSTL
万方数据
维普
