| Objective:This paper carries out a contrastive analysis of clinical effect between Linagliptin combined with CSII and single CSII in newly diaglosed T2 DM patients.The research can provide more choices for the follow-up suggestion of intensive insulin treatment.Method:A total of 150 patients with newly diagnosed T2 DM from January in 2015 to January in 2016 were enrolled from our hospital.After follow-up,the patients were divided into the linagliptin group and the control group,with 58 patients in each group.The linagliptin group was administered with linagliptin combined with CSII.While the control group was given with single CSII.According to the glucose level,when the glucose reaches the standardtreatment and the amount of insulin’s being reduced to 0u gradually after 10~14 days treatment,the patients discharged.In the control group,the patients receive the intervention of life factors.While in the linagliptin group,the patients continuously take linagliptin for 12 weeks.Then divide the linagliptin group into subgroup 1(having linagliptin for 12 weeks and then receiving the intervention of life factors with linagliptin withdrawal),subgroup 2(having linagliptin for 24 weeks)at random.The BMI,FPG,2hPG,HbA1 c,FINS,TG,TC,LDL-C were measured before and after the treatment,and calculate HOMA-IS and HOMA-IR.The number of days in hospital and treatment costs are recorded until the patients are discharged.Result:A total of 116 patients in this study were followed up for 24 weeks,58 patients in each group.After 12 weeks,the linagliptin group was divided into subgroup 1(28 patients)and subgroup 2(30 patients).FPG,2hPG,HbA1 c in the linagliptin group and the control group significantly decreased(p<0.05)compared to those at baseline.However,the FPG,2hPG,HbA1 c in linagliptin group were significantly better than those in the control group(p<0.05).Besides,2hPG in the control group at 12 th week and 24 th week significantly increased compared to that at 4th week(p<0.05).HOMA-IS in both groups had no significant change at all follow-up points compared to that at baseline(p>0.05).But HOMA-IS in the linagliptin group increased at 24 th weekcompared to that at12 th week and the control group(p<0.05).HOMA-IR in both groups significantly increased compared to that at baseline(p<0.05).HOMA-IR in the linagliptin group was better than that in the control group at 4th week(p<0.05).TG in the control group significantly decreased at 12 th,24th week compared to that at baseline and 4th week(p<0.05).TG in the linagliptin group significantly decreased at all follow-up points compared to that at baseline(p<0.05).And it significantly decreased at 12 th week and 24 th week compared to that at 4th week(p<0.05).TG in the linagliptin group was better than that in the control group at 24 th week(p<0.05).TC in the linagliptin group and the control group significantly decreased at 12 th week and 24 th week compared to that at baseline and 4th week(p<0.05).The linagliptin group was significantly better than that in the control group(p<0.05).LDL-C in the control group significantly decreased at 12 th week and 24 th week compared to that at baseline and 4th week(p<0.05).LDL-C in the linagliptin group significantly decreased at all follow-up points compared to that at baseline(p<0.05).And it significantly decreased at 12 th week and 24 th week compared to that at 4th week(p<0.05).But there was no significant difference in LDL-C between the two groups(p>0.05).BMI in the linagliptin group and the control group significantly decreasedcompared to that at baseline(p<0.05).However,the BMI in the linagliptin group was significantly better than that in the control group(p<0.05).And the BMI in the control group at 24 th week significantly increased comepared to that at 4th week and 12 th week(p<0.05).The number of days in hospital and treatment costs in the linagliptin group significantly less than those in the control group(p<0.05).The FPG in the subgroup 2 significantly decreased at 24 th week compared to that at 12 th week.FPG in the two subgroups was significantly better than that in control group at 24 th week(p<0.05).2hPG and HbA1 c in the two subgroups were significantly better than those in the control group at 12 th week and 24 th week(p<0.05).HOMA-IS in the subgroup 2 significantly increased at 24 th week compared to that at 12 th week.HOMA-IS in the subgroup 2 was significantly better than that in the control group at 12 th week(p<0.05).HOMA-IR in the subgroup 1,subgroup2 and the control group significantly decreased at 24 th week compared to that at 12 th week(p<0.05).TG in the subgroup 2 at 24 th week significantly decreased compared to that at 12 th week(p<0.05).And TG in the subgroup 2 at 24 th week was significantly better than that in control group(p<0.05).TC in the subgroup 1 and subgroup 2 at 24 th week significantly decreased compared to that in the control group(p<0.05).BMI in the control group and subgroup 2 at 24 th week significantly decreased compared to that at 12 th week(p<0.05).There were no significant differences in all index between two subgroups(p>0.05).Conclusion:For the patients with newly diagnosed type 2 diabetes,linagliptin combined with CSII can effectively control blood glucose levels,improve insulin resistance,promote the recovery of islet function,lose weight,reduce blood lipids,shorten the days in the hospital and reduce the costs compared with single CSII.After the patients with newly diagnosed type 2 diabetes entered the honeymoon period by receiving the intensification therapy with CSII,there is no significant difference between the ones receiving three-month therapy of linagliptin and the ones receiving six-month therapy of linagliptin.The result can only be reference for clinical medication time. |
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