Abstract：Objective To analyze the clinical efficacy and safety of Linagliptin combined with Insulin in patients with type 2 diabetes mellitus (T2DM) and concurrent nephropathy. Methods From June 2017 to December 2018 in Hebei Petrochina Central Hospital, 96 patients with early diabetic nephropathy inpatient and outpatient were selected as the subjects. They were divided into treatment group 48 cases (Insulin + Linagliptin), control group 48 cases (insulin) by random number table method. Patients in both groups were treated with Valsartan Capsules 80 mg orally to reduce urinary protein on the basis of hypoglycemic therapy for 16 weeks. The changes of each index before and after treatment were compared between the two groups, indicators including fasting plasma glucose (FPG), 2 h postprandial blood glucose (2 HPG), glycosylated hemoglobin (HbA1c), serum creatinine (CR), 24 h urine trace albumin urinary inhibition (M-A1b), cystatin (Cys-C), the steady-state model of insulin resistance index (HOMA-IR) and islet β cell function index (HOMA-β), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), three acyl glycerin (TG), body mass index (BMI) and insulin dosage. Results Compared with before treatment, FPG, 2hPG and HbA1c indexes of the two groups decreased after treatment (P ＜ 0.05). The LDL-C and TG indexes in the treatment group were reduced, and the difference was statistically significant (P < 0.05), while the differences in LDL-C and TG between before and after treatment of the control group was not statistically significant (P ＞ 0.05), and the difference in the treatment group was lower than that in the control group (P ＜ 0.05). BMI in the two groups, the difference was not statistically significant (P ＞ 0.05). HOMA-IR was reduced in the two groups, and the treatment group was lower than the control group (P ＜ 0.05). HOMA-β increased in the two groups, and the treatment group was higher than the control group (P ＜ 0.05). The amount of insulin in the control group increased, and the amount of insulin in the treatment group decreased, and the treatment group was lower than that in the control group (P ＜ 0.05). The increase of CR and Cys-C between the two groups before and after treatment was not statistically significant (P ＞ 0.05). The M-A1b in the two groups was decreased(P ＜ 0.05), but the difference between two groups was not statistically significant (P ＞ 0.05). Conclusion The combination of Linagliptin and Insulin in the treatment of T2DM patients can effectively reduce the blood glucose, reduce the amount of insulin and regulate the blood lipid，and help reduce the urine protein in patients with diabetic nephropathy.
李立1 张朝云2 卢姗1 潘丹1 石蕊1 苏微微3 李陆4 赵可新1. 利格列汀联合胰岛素治疗2型糖尿病合并肾病的临床效果[J]. 中国医药导报, 2020, 17(17): 173-176.
LI Li1 ZHANG Chaoyun2 LU Shan1 PAN Dan1 SHI Rui1 SU Weiwei3 LI Lu4 ZHAO Kexin1. Clinical effect of Linagliptin combined with Insulin in the treatment of type 2 diabetes mellitus with nephropathy. 中国医药导报, 2020, 17(17): 173-176.
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2020, Vol. 17 
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