目的 探讨多格列艾汀联合二甲双胍治疗初发超重/肥胖2型糖尿病(type 2 diabetes mellitus,T2DM)患者的有效性及安全性.方法 选取2023年10月至2024年4月于荆州市中心医院内分泌科新诊断的初发超重/肥胖T2DM患者80例,采用随机数字表法将其分为对照组和观察组,每组40例.对照组患者给予二甲双胍治疗,观察组患者给予多格列艾汀联合二甲双胍治疗.治疗12周后,比较两组患者的治疗效果及治疗前后的空腹血糖(fasting blood glucose,FBG)、餐后2h血糖(2-h postprandial blood glucose,2hPG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、胰岛β细胞功能指数(homeostasis model assessment forβcell function,HOMA-β)、稳态模型评估的胰岛素抵抗(homeostasis model assessment of insulin resistance,HOMA-IR)指数、2型糖尿病患者生活质量量表(quality of life scale for patients with type 2 diabetes mellitus,DMQLS)评分、估算肾小球滤过率、肝功能、血脂水平变化,记录患者用药期间的不良反应发生情况.结果 观察组患者的总有效率显著高于对照组(95.00％vs.77.50％,x2=5.165,P=0.023).治疗后,两组患者的FBG、2hPG、HbA1c、HOMA-IR指数、体质量指数均显著低于本组治疗前,HOMA-β、DMQLS评分均显著高于本组治疗前(P<0.05),且观察组患者的FBG、2hPG、HbA1c、HOMA-IR指数、体质量指数均显著低于对照组,HOMA-β、DMQLS评分均显著高于对照组(P<0.05).两组患者在治疗过程中均未出现严重不良反应(P>0.05).结论 多格列艾汀联合二甲双胍治疗初发超重/肥胖T2DM患者的效果显著,可有效控制患者血糖水平,改善胰岛细胞功能,减轻体质量,提高生活质量,临床应用价值较为突出.
Study on the efficacy and safety of dorzagliatin combined with metformin in the treatment of type 2 diabetes mellitus patients with initially overweight/obesity
Objective To investigate the safety and efficacy of dorzagliatin combined with metformin in the treatment of type 2 diabetes mellitus (T2DM) patients with initially overweight/obesity. Methods Eighty T2DM patients with initially overweight/obesity diagnosed in the Department of Endocrinology of Jingzhou Central Hospital from October 2023 to April 2024 were selected. They were divided into control group and observation group with 40 cases in each group by random number table method. Control group was treated with metformin,observation group was treated with dorzagliatin combined with metformin. After 12 weeks of treatment,the therapeutic effects,and fasting blood glucose (FBG),2-h postprandial blood glucose (2hPG),glycosylated hemoglobin (HbA1c),homeostasis model assessment for β cell function (HOMA-β),homeostasis model assessment of insulin resistance (HOMA-IR) index,quality of life scale for patients with type 2 diabetes mellitus (DMQLS) scores,estimated glomerular filtration rate,liver function and lipid level before and after treatment were compared between two groups. The occurrence of adverse reactions during medication was recorded. Results The total effective rate of observation group was significantly higher than that of control group (95.00％ vs. 77.50％,x2=5.165,P=0.023). After treatment,FBG,2hPG,HbA1c,HOMA-IR index and body mass index of patients in both groups were significantly lower than before treatment,while HOMA-β and DMQLS scores were significantly higher than before treatment (P<0.05). FBG,2hPG,HbA1c,HOMA-IR index and body mass index of patients in observation group were significantly lower than those in control group,while HOMA-β and DMQLS scores were significantly higher than those in control group (P<0.05). There were no serious adverse reactions occurred during treatment in two groups (P>0.05). Conclusion The effect of dorzagliatin combined with metformin in the treatment of T2DM patients with initially overweight/obesity is remarkable. It can effectively control the level of blood glucose,improve the function of pancreatic islet cells,lose weight,and improve the life quality of patients. Its clinical application value is outstanding.
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