2022 年第 8 期 第 17 卷

达格列净联合胰岛素泵治疗新诊断2型糖尿病的效果及对血糖波动的影响

Effect of dapagliflozin combined with insulin pump on newly diagnosed type 2 diabetes mellitus and its influence on blood glucose fluctuation

作者：焦秀敏刘佳符静王广

英文作者：Jiao Xiumin Liu Jia Fu Jing Wang Guang

单位：首都医科大学附属北京朝阳医院内分泌科，北京100020

英文单位：Department of Endocrinology Beijing Chao-yang Hospital Capital Medical University Beijing 100020 China

关键词：2型糖尿病；达格列净；胰岛素泵

英文关键词：Type2diabetesmellitus;Dapagliflozin;Insulinpump

• 摘要：

• 目的 探讨达格列净联合胰岛素泵治疗新诊断2型糖尿病（T2DM）的疗效及其对血糖波动的影响。方法 选取2021年1月至2022年1月于首都医科大学附属北京朝阳医院内分泌科住院的新诊断T2DM患者41例进行回顾性分析。按照治疗方法不同，将患者分为对照组（20例）和观察组（21例）。对照组予胰岛素泵注射赖脯胰岛素，观察组在对照组基础上联合达格列净治疗。记录患者住院时间及血糖监测相关指标，比较2组入院第2天、治疗1周后的最大血糖波动幅度 (LAGE)、日内血糖标准差(SDBG)、餐后血糖平均波动幅度 (PPGE)及日内血糖平均波动幅度(MAGE)。结果 观察组住院时间、血糖达标时间、初次达标时胰岛素用量、停泵前胰岛素用量均短于/少于对照组（均P＜0.05）。2组治疗1周后LAGE、SDBG、PPGE、MAGE均明显低于入院第2天，且观察组明显低于对照组［（8.4±2.6）mmol/L比（14.2±2.1）mmol/L、（2.4±0.7）mmol/L比（5.2±1.0）mmol/L、（2.8±1.3）mmol/L比（6.6±2.1）mmol/L、（2.0±0.7）mmol/L比（4.2±0.8）mmol/L］(均P<0.05)。观察组与对照组治疗期间低血糖发生率比较［19.0%（4/21）比15.0%（3/20）］，差异无统计学意义（P=0.499）。结论 达格列净联合胰岛素泵治疗新诊断T2DM患者，可以改善血糖，减少血糖波动，缩短住院时间，具有一定安全性。

• Objective To discuss the efficacy of dapagliflozin combined with insulin pump on newly diagnosed type 2 diabetes mellitus (T2DM) and its effect on blood glucose fluctuation. Methods From January 2021 to January 2022, totally 41 inpatients with newly diagnosed T2DM who were admitted to Beijing Chao-yang Hospital, Capital Medical University were retrospectively analyzed. According to the treatment methods, patients were divided into control group (20 cases) and observation group (21 cases). The control group was treated with insulin lispro injected by insulin pump, and the observation group was treated with dapagliflozin based on the control group. The length of stay and associated blood glucose monitoring indicators were recorded. Maximum fluctuation range of blood glucose (LAGE), standard deviation of intra day blood glucose (SDBG), average fluctuation range of postprandial blood glucose (PPGE) and average fluctuation range of blood glucose within a day (MAGE) on the 2nd day after admission and 1 week after treatment were compared between the two groups. Results The length of stay, the time of blood glucose reaching the target, the insulin dosage at the initial target and the insulin dosage before the pump stopped in the control group were shorter/less than those in observation group(all P<0.05). One week after treatment, LAGE, SDBG, PPGE and MAGE in both groups were lower than those on the 2nd day after admission and the indexes in the observation group were lower than those in the control group［（8.4±2.6）mmol/L vs （14.2±2.1）mmol/L,（2.4±0.7）mmol/L vs （5.2±1.0）mmol/L,（2.8±1.3）mmol/L vs （6.6±2.1）mmol/L,（2.0±0.7）mmol/L vs （4.2±0.8）mmol/L］(all P<0.05). There was no significant difference in the incidence of hypoglycemia between observation group and control group［19.0%（4/21） vs 15.0%（3/20）］(P=0.499). Conclusion For newly diagnosed T2DM patients, dapagliflozin combined with insulin pump has significant benefits in improving glucose blood, reducing blood glucose fluctuation, shorting length of hospital stay and has certain safety.