The Clinical Efficacy Of Dapagliflozin In The Treatment Of Type 2 Diabetes Mellitus And Its Effect On Inflammatory Factors,Oxidative Stress And Hemorheology

Objective:To explore the clinical efficacy of dapagliflozin combined with metformin in the treatment of type 2 diabetes mellitus and its effect on inflammatory factors,oxidative stress and hemorheology.Methods:160 patients with type 2 diabetes mellitus(T2DM)were selected and randomly divided into observation group and control group,with 80 cases in each group.On the basis of the "four cornerstones"——guidance of reasonable diet,moderate exercise,smoking cessation and alcohol restriction,and psychological balance,the control group was given metformin combined with glimepiride,and the observation group was given dapagliflozin combined with metformin,and the two groups were both treated for 24 weeks.The fasting blood glucose(FPG),2h post-prandial blood glucose(2h-PG),glycosylated hemoglobin(HbA1c),fasting insulin(FINS),homeostasis model insulin resistance index(HOMA-IR),islet beta cell function index(HOMA-β),serum high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)levels of inflammatory factors,serum malondialdehyde(MDA),superoxide dismutase(SOD),total antioxidant capacity(T-AOC).advanced protein oxidation products(AOPP),catalase(CAT)levels of oxidative stress indicators,fibrinogen(FIB),whole blood high shear viscosity(WHV),whole blood low shear viscosity(WLV)and plasma viscosity(PV)of hemorheological indicators were compared between the two groups before treatment and after 24 weeks of treatment.The clinical efficacy and incidence of adverse reactions were compared between the two groups.Results:Before treatment,there was no significant difference in the levels of blood glucose,insulin resistance,serum inflammatory factors,oxidative stress indexes and hemorheology indexes between the two groups(P>0.05).24 weeks after treatment,FPG,2h-PG,HbA1c,HOMA-IR,serum IL-6,TNF-α,hs-CRP,MDA,AOPP,fibrinogen,whole blood high shear viscosity,whole blood low shear and plasma viscosity in two groups were decreased in different degrees(P<0.05 or P<0.01),and the levels of Flns,HOMA-β,T-AOC,SOD,and CAT were increased in various degrees(P<0.05 or P<0.01).The levels of FPG,2h-PG,HbA1c,HOMA-IR,serum IL-6,TNF-α,hs-CRP,MDA,AOPP,fibrinogen,whole blood high shear viscosity,whole blood low shear viscosity and plasma viscosity in observation group were lower than those in the control group(P<0.05).The levels of FIns,HOMA-β,T-AOC,SOD,and CAT were higher than those in the control group(P<0.05).The levels of TC,TG and LDL-C in the observation group were lower than those in the control group,while the levels of HDL-C were higher than those in the control group,the difference was statistically significant(P<0.05).The total effective rate of the observation group was higher than that of the control group(92.41%vs.76.92%,P<0.05).The incidence of adverse reactions in the observation group and the control group were 7.59%and 12.82%respectively,and there was no significant difference(P>0.05).Conclusion:Dapagliflozin combined with metformin in the treatment of type 2 diabetes can significantly decrease the blood glucose level,insulin resistance,serum inflammatory factors and oxidative stress index levels,improve insulin β-cell function,and improve hemorheology indexes,with good clinical efficacy and high safety.