Clinical trial of dapagliflozin combined with insulin pump intensive therapy on elderly patients with T2DM
Objective To analyze the effects of dapagliflozin combined with insulin pump intensive therapy on elderly patients with type 2 diabetes mellitus(T2DM).Methods Elderly patients with T2DM were divided into control group and treatment group according to the random number table method.The control group was given insulin pump intensive therapy(pumping insulin aspart ejection at initial dose of 0.3-0.5 U·kg-1;dose of insulin aspart was adjusted according to the blood glucose monitoring,the insulin was stopped and the oral hypoglycemic drug was given when fasting plasma glucose was controlled at 4.4-7.0 mmol·L-1 and postprandial blood glucose was 4.4-10.0 mmol·L-1),and the treatment group was treated with 10 mg of dapagliflozin tablets once a day on this basis.Both groups of patients were continuously treated for 12 weeks.Blood glucose fluctuation indicators[mean amplitude of glycemic excursions(MAGE),largest amplitude of glycemic excursions(LAGE)],peripheral blood nuclear factor erythroid 2-related factor 2(Nrf2),Kelch-like ECH associated protein 1(Keap1)and occurrence of major adverse cardiac events(MACE)and adverse drug reactions were compared between the two groups.Results Thus 98 cases were included in control group and treatment group,respectively.After treatment,the total effective rates in control group and treatment group were 83.67％(82 cases/98 cases)and 92.86％(91 cases/98 cases);MAGE values were(3.63±0.54)and(3.38±0.49)mmol·L-1;LAGE values were(8.41±1.45)and(7.53±1.26)mmol·L-1;Nrf2 levels were(8.06±1.29)and(6.82±1.03)ng·mL-1;Keap1 levels were(7.22±1.07)and(6.09±0.86)ng·mL-1(all P＜0.05).There were no statistically significant differences in the incidence rates of MACE and adverse drug reactions between the two groups(P＞0.05).Conclusion Dapagliflozin combined with insulin pump intensive therapy for elderly patients with T2DM can effectively control the blood glucose level,reduce the blood glucose fluctuation,relieve the body's oxidative stress response,and reduce the levels of Nrf2 and Keap1,and it may lower the cardiovascular risk.
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