A Comparative Study Of The Clinical Observation Of Insulin Glargine Combined With Saxagliptin And Premixed Insulin In The Treatment Of Elderly Type 2 Diabetes

Objectives:Compare the clinical efficacy,adverse reactions,compliance,satisfaction and pharmacoeconomics of Insulin glargine combined with saxagliptin and premixed insulin in the treatment of elderly patients with type 2 diabetes mellitus who failed oral drug therpy.Methods:Eighty-one elderly patients with type 2 diabetes treated at the endocrinology department of Hunan Provincial People's Hospital from January 2017 to December 2017 were randomly selected according to the treatment.The eligible patients were divided into two groups.The patients in the observation group were given insulin glargine combined with oral saxagliptin,and patients in the control group received two injections of premixed insulin.After three months of treatment,the clinical efficacy,adverse reactions,compliance,satisfaction,and pharmacoeconomics of the two groups were compared.Results: 1.Before treatment,there was no significant difference in the level of the general information(sex,age,course of disease,BMI),blood glucose index(FBG,2h PBG,Hb A1c),islet function index(FC-P,2h C-P)and blood lipid index(TG,TC,LDL-C and HDL-C)between the two group(P>0.05).2.After 3 months of treatment,compared with before treatment,the blood glucose parameters FBG,2h PBG,and Hb A1 c decreased in both groups(P<0.05).There was no significant difference in blood glucose levels between the two groups after treatment(P>0.05).3.After 3 months of treatment,compared with before treatment,the indexes of pancreatic islet function FC-P,2h C-P were higher than before(P<0.05),There was no significant difference in the islet function index between the two groups(P>0.05).4.After 3 months of treatment,compared with before treatment,the serum lipids TG,TC,and LDL-C in both groups were lower than before(all P<0.05),and there was no significant change in HDL-C(P>0.05).However,compared with the control group,the levels of TG,TC,and LDL-C in the observation group were decreased more significantly(P<0.05).5.After 3 months of treatment,compared with before treatment,the BMI of the observation group was lower than before(P<0.05),while the BMI of the control group was higher than before(P<0.05),and compared with the control group,the BMI of observation group was significantly decreased(P<0.05).6.During the treatment period,compared with the control group,the incidence of hypoglycemia in the observation group was lower(P<0.05),and the compliance and satisfaction were higher(P<0.05),but the average daily cost of hypoglycemic drugs was relatively higher(P<0.05).Conclusion: 1.Compared with premixed insulin,insulin glargine combined with saxagliptin in elderly patients with type 2 diabetes has a better effect on improving the blood lipids,reducing weight with lower incidence of hypoglycemia,better drug compliance and satisfaction,but the drug cost is relatively high.2.Insulin glargine combined with saxagliptin is one of the best options for treatment of elderly patients with type 2 diabetes.