|
|
Clinical efficacy of Dapagliflozin combined with Metformin in the patients with type 2 diabetes mellitus |
TIAN Rui BEN Lyuhong |
Department of Endocrinology,DongGuan Tungwah Hospital,Guangdong Province,Dongguan 523110,China |
|
|
Abstract Objective To investigate the efficacy and safety of Dapagliflozin combined with Metformin in the patients with type 2 diabetes mellitus and provide evidence of clinical trantment.Methods A total of 105 patients newly diagnosed with T2DM in DongGuan Tungwah Hospital from May 2019 to August 2020 were selected as the research objects.According to the simple randomized principle,the patients were divided into the Dapagliflozin group(27 patients),Saxagliptin group(26 patients),Acarbose group(27 patients)and Glimepiride group(25 patients).All groups were simultaneously treated with Metformin for 12 weeks.Body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting blood glucose(FPG),2 hours postprandial blood glucose(PBG),glycated hemoglobin(HbA1c),islet β-cell function index(HOMA-β),serum uric acid(SUA),serum creatinine(SCr),total cholesterol(TC)and triacylglycerin in 4 groups were compared(TG),alanine aminotransferase(ALT),alanine aminotransferase(AST)levels and adverse reactions were cimpared among the four groups.Results Before treatment,there were no significant differences in BMI,SBP,DBP,FPG,PBG,HbA1c,SUA,SCr,TC,TG,ALT and AST among the four groups(P>0.05).After treatment,the levels of FPG,PBG,HbA1c and HOMA-β in the four groups were lower than those before treatment,the differences were statistically significant(P<0.05).After treatment,The BMI,SBP,TC,TG and SUA of Dagaglipin group were lower than those before treatment,the differences were statistically significant(P<0.05).After treatment,FPG,HbA1c,HOMA-β,BMI,SBP,TG and SUA in Dagagliptin group were lower than those in Saxagliptin group,Acarbose group and Glimepirea group(P<0.05).The total incidence of adverse events in the Dagagligin group was 3.7%,lower than that in the Acarbose group(29.6%),and the difference was statistically significant(P<0.05).Conclusion Dapagliflozin plus Metformin have better treatment results in patients with T2DM mellitus.It can effectively reduce blood glucose fluctuations,and improve many metabolic indexes.There is no obvious gastrointestinal reaction and high safety,which is worthy of promotion.
|
|
|
|
|
[1] |
Li Y,Teng D,Shi X,et al.Prevalence of diabetes recorded in mainland china using 2018 diagnostic criteria from the American Diabetes Association:national cross sectional study[J].BMJ,2020,28:369.
|
[2] |
中华医学会内分泌学分会.中国成人2 型糖尿病口服降糖药联合治疗专家共识[J].中华内分泌代谢杂志,2019,35(3):190-199.
|
[3] |
母义明,李春霖,纪立农,等.二甲双胍临床应用专家共识(2018年版)[J].中国糖尿病杂志,2019,27(3):161-173.
|
[4] |
苏青.浅谈成人2 型糖尿病患者糖化血红蛋白控制目标及达标策略[J].中华糖尿病杂志,2020,12(1):13-16.
|
[5] |
中华医学会内分泌学分会,中华医学会糖尿病学分会,中国医师协会内分泌代谢科医师分会,等.中国成人糖尿病前期干预的专家共识[J].中华内分泌代谢杂志,2020,36(5):371-380.
|
[7] |
中华医学会糖尿病学分会.中国2 型糖尿病防治指南(2017年版)[J].中华糖尿病杂志,2018,10(1):4-67.
|
[6] |
Perry RJ,Shulman GI.Sodium-glucose cotransporter-2 inhibitors:understanding the mechanisms for therapeutic promise and persisting risks[J].J Biol Chem,2020,95(42):14 379-14 390.
|
[8] |
American Diabetes Association.9.Pharmacologic approaches to glycemic treatment:standards of medical care indiabetes-2021[J].Diabetes Care,2020,43(Suppl 1):S98-S110.
|
[9] |
张波,杨文英.钠-葡萄糖共转运蛋白2 抑制剂(SGLT2i)在治疗2型糖尿病中的有效性和安全性[J].中华内分泌代谢杂志,2016,32(2):171-176.
|
[10] |
刘林,王薇,张婷婷,等.达格列净对2 型糖尿病患者血、尿电解质及尿酸影响的病例观察[J].中国糖尿病杂志,2020,28(5):345-349.
|
[11] |
Marx N,Davies MJ,Grant PJ,et al.Guideline recommendations and the positioning of newer drugs in type 2 diabetes care[J].Lancet Diabetes Endocrinol,2019,9(1):46-52.
|
[12] |
陈耿钦.达格列净对2 型糖尿病合并代谢综合征患者糖脂代谢和氧化应激指标的影响[J].中国医药科学,2021,11(3):119-122.
|
[13] |
卢琳,何杰,李培培,等.达格列净联合二甲双胍治疗肥胖2 型糖尿病合并OSAS 疗效及安全性的Meta 分析[J].疑难病杂志,2020,19(8):778-784.
|
[14] |
田睿.达格列净治疗初诊2 型糖尿病的临床效果[J].中国当代医药,2020,27(10):83-86.
|
[15] |
包丽雯,刘荣宸,严芳英,等.钠-葡萄糖共转运体2 抑制剂治疗心血管疾病的研究进展[J].中华心血管病杂志,2020,48(4):339-343.
|
[16] |
中华医学会糖尿病学分会,中华医学会内分泌学分会.中国成人2 型糖尿病合并心肾疾病患者降糖药物临床应用专家共识[J].中华糖尿病杂志,2020,12(6):369-381.
|
[17] |
左庆娟,和丽丽,马赛,等.钠-葡萄糖共转运蛋白-2 抑制剂对心血管的保护作用[J].中华内科杂志,2021,60(1):75-79.
|
[18] |
伍豪,孙芳,祝之明.钠-葡萄糖共转运蛋白2 抑制剂改善代谢综合征机制的研究进展[J].中华糖尿病杂志,2021,13(1):107-111.
|
[19] |
European Society of Cardiology.2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure[J].Eur Heart J,2021,42(36):3599-3726.
|
[20] |
American Diabetes Association.Standards of Medical Care in Diabetes-2021[J].Diabetes Care,2021,44(Suppl 1):S1-S2.
|
|
|
|