|
|
|
| Efficacy and safety of Sitagliptin combined with insulin in the treatment of type 1 brittle diabetes |
| LIU Jiao1 XING Xiaolei2 ZHANG Min2 LYU Jing1 WAN Meng1 YANG Yang2▲ |
1.Clinical College, Wuhan University of Science and Technology, Hubei Province, Wuhan 430064, China;
2.Department of Endocrinology, Tianyou Hospital, Wuhan University of Science and Technology, Hubei Province, Wuhan 430064, China |
|
|
|
Abstract Objective To investigate the clinical efficacy and safety of Sigliptin combined with insulin in the treatment of type 1 brittle diabetes mellitus. Methods A total of 80 patients with type 1 brittle diabetes were selected from September 2016 to April 2018 in Tianyou Hospital, Wuhan University of Science and Technology. They were divided into control group and observation group by odd even random method, with 40 patients in each group. The control group was treated with insulin, while the observation group was treated with Sigliptin on the basis of the control group. The course of treatment was three months. The blood sugar index, islet function, incidence of adverse reactions and frequency of hypoglycemia were compared between the two groups. Results There was no significant difference in FBG, 2 h PBG and HbA1c between the two groups before treatment (P ＞ 0.05). After treatment, FBG, 2 h PBG and HbA1c in the two groups were lower than those before treatment (P ＜ 0.05), and PBG, 2 h PBG and HbA1c in the observation group were lower than those in the control group (P ＜ 0.05). There was no significant difference in fasting C-peptide and postprandial 2 h C-peptide between the two groups before treatment (P ＞ 0.05). After treatment, the fasting C-peptide and postprandial 2 h C-peptide in the two groups were higher than those before treatment (P ＜ 0.05), and the fasting C-peptide and postprandial 2 h C-peptide in the observation group were higher than those in the control group (P ＜ 0.05). The incidence of adverse reactions and the frequency of hypoglycemia in the observation group were significantly lower than those in the control group (P ＜ 0.05). Conclusion Insulin can reduce blood sugar and improve islet function in patients with type 1 brittle diabetes mellitus, but the effect of Sitagliptin combined with insulin in the treatment of type 1 brittle diabetes mellitus is more significant, and the occurrence of hypoglycemic events is less, which can stabilize blood sugar well, and the incidence of adverse events is low. It has high safety and is worth promotion in clinic.
|
|
|
|
|
|
[1] 刘巍，陈适，肖新华，等.西格列汀治疗脆性糖尿病一例并文献复习[J].中华临床医师杂志：电子版，2013，7（16）：7436-7439.
[2] 刘新民.实用内分泌学[M].2版.北京：人民军医出版社，1997：356-358.
[3] Carrami?觡ana FCB. Use of dipeptidyl peptidase-4 inhibitors in patients with diabetes [J]. Semergen，2018，44：10-17.
[4] 汤云昭，田琳琳，倪长霖.DPP-4抑制剂的安全性研究进展[J].医学综述，2018，24（4）：770-775.
[5] 蔡春沉，贾红卫，李艳霞，等.二肽基肽酶4抑制剂西格列汀对胰岛基质细胞衍生因子1α降解及胰岛β细胞再生的影响[J].中国糖尿病杂志，2017，25（5）：458-463.
[6] Shah P，Ardestani A，Dharmadhikari G，et al. The DPP-4 inhibitor linagliptin restores β-cell function and survival in human isolated islets through GLP-1 stabilization [J]. J Clin Endocrinol Metab，2013，98（7）：E1163-E1172.
[7] 曹筱佩.二肽基肽酶4抑制剂在东亚2型糖尿病患者中的应用与机制探讨[J].中华内分泌代谢杂志，2017，33（12）：1071-1074.
[8] 陈鑫，张菁.西格列汀在糖尿病治疗中的药理作用及临床评价[J].中国医药，2018，13（3）：467-470.
[9] Deacon CF. Dipeptidyl peptidase-4 inhibitors in the treatment of type 2 diabetes：a comparative review [J]. Diabetes，Obesity and Metabolism，2011，13（1）：7-18.
[10] 谢婧，纪立伟.老年2型糖尿病患者使用二肽基肽酶4抑制剂的疗效和安全性评价[J].中国糖尿病杂志，2018， 26（2）：173-176.
[11] 叶海燕，陈平.维格列汀联合二甲双胍与短期胰岛素强化治疗2型糖尿病的临床疗效[J].西部医学，2017，29（10）：1393-1396.
[12] 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，2018，38（4）：4-67.
[13] Ohmura H，Mita T，Taneda Y，et al. Efficacy and Safety of Sitagliptin in Japanese Patients With Type 2 Diabetes [J]. J Clin Med Res，2015，7（4）：211-219.
[14] 邢春燕.肠促胰岛素在1型糖尿病中的作用和应用前景[J].医学综述，2014，20（2）：309-312.
[15] 罗娜，朱妍，张真稳，等.西格列汀联合胰岛素治疗脆性糖尿病的临床观察[J].中南大学学报：医学版，2015，40（10）：1089-1095.
[16] Ellis SL，Moser EG，Snell-Bergeon JK，et al. Effect of sitagliptin on glucose control in adult patients with Type 1 diabetes：a pilot，double-blind，randomized，crossover trial [J]. Diabet Med，2011，28（10）：1176-1181.
[17] Giampietro O，Giampietro C，Bartola LD，et al. Sitagliptin as add-on therapy in insulin deficiency： biomarkers of therapeutic efficacy respond differently in type 1 and type 2 diabetes.[J]. Drug Des Devel Ther，2013，7：99-104.
[18] Kutoh E. Sitagliptin is effective and safe as add-on to insulin in patients with absolute insulin deficiency：a case series [J]. J Med Case Rep，2011，5（1）：117.
[19] Derosa G，D′Angelo A，Maffioli P. Sitagliptin in type 2 diabetes mellitus：efficacy after five years of therapy [J]. Pharmacol Res，2015，100：127-134.
[20] Kocak MZ，Aktas G，Erkus E，et al. A Case of Sitagliptin-Induced Mild Acute Pancreatitis [J]. J Coll Physicians Surg Pak，2018，28（4）：334. |
|
|
|
