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中华肥胖与代谢病电子杂志 ›› 2022, Vol. 08 ›› Issue (01) : 24 -29. doi: 10.3877/cma.j.issn.2095-9605.2022.01.004

论著

达格列净联合短期胰岛素强化治疗对初治2型糖尿病患者代谢指标的影响
林敏1,()   
  1. 1. 523000 广东省东莞市,东莞东华医院内分泌科
  • 收稿日期:2021-10-10 出版日期:2022-02-28
  • 通信作者: 林敏
  • 基金资助:
    东莞市社会科技发展(一般)项目(2018507150461270)

Metabolic effects of dapagliflozin combined with short-term intensive insulin therapy in patients with newly-diagnosed type 2 diabetes mellitus

Min Lin1,()   

  1. 1. Department of Endocrinology, Dongguan Tungwah Hospital, Dongguan 523000, China
  • Received:2021-10-10 Published:2022-02-28
  • Corresponding author: Min Lin
引用本文:

林敏. 达格列净联合短期胰岛素强化治疗对初治2型糖尿病患者代谢指标的影响[J/OL]. 中华肥胖与代谢病电子杂志, 2022, 08(01): 24-29.

Min Lin. Metabolic effects of dapagliflozin combined with short-term intensive insulin therapy in patients with newly-diagnosed type 2 diabetes mellitus[J/OL]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2022, 08(01): 24-29.

目的

探讨新诊断2型糖尿病(T2DM)患者在短期胰岛素强化治疗的基础上联用达格列净对代谢指标的影响。

方法

入选2018年5月至2020年8月于东莞东华医院内分泌科住院的新诊断T2DM患者60例,随机分为试验组(短期胰岛素强化+达格列净)和对照组(短期胰岛素强化),收集治疗前(d0)、血糖达标后14天(D14)及停药后随访第12周(W12)的资料,分析两组患者的代谢指标的变化。

结果

两组患者的体重、体质量指数(BMI)及腰围在W12时仍出现明显下降,且试验组下降更显著;试验组的血尿酸(UA)在D14出现明显下降,但停药后明显回升,而对照组的UA治疗前后无明显变化;两组患者的甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)在治疗后均出现明显下降,试验组高密度脂蛋白胆固醇(HDL-C)在停药后明显升高,而对照组治疗前后无明显变化。

结论

对于新诊断的T2DM患者,在早期胰岛素强化降糖的同时加用达格列净治疗,可更显著减少体重、BMI、腰围,改善患者HDL-C等代谢指标。

Objective

To explore metabolic effects of dapagliflozin combined with short-term intensive insulin therapy in patients with newly-diagnosed T2DM.

Methods

Sixty participants were recruited and randomized to the trial group (receive intensive insulin therapy and dapagliflozin) or the control group (intensive insulin therapy). Data was collected at baseline (d0), 14 days after reaching euglycemia (D14) and at the 12-week visit (W12).

Results

Weight, BMI and waist circumference decreased at W12 in both groups, and the change was more significant in the trial group. In the trial group, serum UA decreased at D14 but significantly elevated at W12, while no change was observed in the control group. TG, TC and LDL-C were decreased in both groups. For HDL-C, the trial group witnessed a significant elevation while no obvious change in the control group.

Conclusions

Dapagliflozin combined with short-term intensive insulin therapy was effective in weight, BMI and waist circumference control, and further improving metabolic indices such as HDL-C.

表1 入组患者基线资料比较
表2 两组患者代谢指标比较
图1 两组患者的体重(1A)、BMI(1B)和腹围(1C)比较注:*P<0.05,**P<0.01,***P<0.001
图2 两组患者的UA比较注:*P<0.05,**P<0.01,***P<0.001
图3 两组患者的TG(±s)(3A)、TC(3B)、LDL-C(3C)和HDL-C(3D)比较注:*P<0.05,**P<0.01,***P<0.001
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