单用二甲双胍血糖控制不佳时联合西格列汀治疗的临床效果

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Abstract

Objective To explore the clinical effect of combined treatment with Sitagliptin when blood glucose is poorly controlled with Metformin alone. Methods A total of 105 patients with type 2 diabetes mellitus who were treated in our hospital from January 2017 to October 2019 were selected as the research objects, 5 cases fell out and 100 cases were eventually enrolled. They were divided into three groups by the random number table method, namely Metformin alone group (group A, n=30), Metformin+Acarbose group (group B, n=35), and Metformin+Sitagliptin group (group C, n=35).The glycated hemoglobin (HbA1c), 1,5-anhydroglucose (1,5-AG), malondialdehyde (MDA), stromal cell-derived factor-1α (SDF-1α) before and after treatment were compared among the three groups, and the incidence of adverse reactions was recorded in the three groups. Results After treatment, the HbA1c and MDA in group B and C were lower than those in group A, and the differences were statistically significant (P<0.01). There were no significant differences in HbA1c and MDA between group B and group C after treatment (P>0.05). The 1,5-AG in group B and C was higher than that in group A at different visit periods after treatment, and the difference was statistically significant (P<0.05).The 1,5-AG in group C was higher than that in group B in visit period 2 and visit period 3, and the difference was statistically significant (P<0.05). There was no significant difference in SDF-1α in group A and group B before and after treatment (P>0.05). The SDF-1α in group C after treatment was higher than that before treatment and in group A and group B, and the difference was statistically significant (P<0.01). The total incidence of adverse reactions in group A and group C was lower than that in group B, and the difference was statistically significant (P<0.05). Conclusion When blood glucose is poorly controlled with Metformin alone, the combination of Sitagliptin or Acarbose both can reduce the level of HbA1c in a tantamount effect; however, the combination of Sitagliptin has smaller blood glucose fluctuations and can reduce oxidative stress and cellular damage, and can improve atherosclerosis, which is an optimal glucoselowering program.

Key words： Glycated hemoglobin Blood glucose fluctuations 1,5-anhydroglucose Malondialdehyde Stromal cell-derived factor-1α

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