| Objective:In order to investigate the effect of using insulin aspart and insulin detemir or combined with sitagliptin on blood glucose fluctuation in patients with type 2 diabetes mellitus,the changes of blood glucose in two groups were compared.To provide more evidence for the clinical use of drugs.Methods:From November 1st 2016 to May 31 st 2017,40 patients with type 2diabetes mellitus were admitted to the Department of Endocrinology who were meet the WHO diagnostic criteria for diabetes 1999 and whose blood glucose were not under controlled(Hb Alc> 7.0%),they were randomly divided into two groups: the control group(n = 20)and the experimental group(n = 20).All inpatients stopped taking hypoglycemic drugs after admission,we collected their basic clinical information and gave them education on diabetic diet and exercise.From the second day after admission,they were treated with the same lifestyle intervention.The control group was given aspart insulin(70percent of 0.4 U / kg / d),which was subcutaneously injected before three meals,and detemir insulin(30 percent of 0.4 U / kg / d),which was subcutaneously injected before going to bed;the experimental group was given sitagliptin 100 mg before breakfast on the basis of the control group.To monitor the blood glucose at the fingertips seven times a day(half an hour before three meals,2 hours after meals and before bedtime)to regulate thedose of insulin and make blood glucose under control(fasting blood glucose <7mmol / L,postprandial blood glucose < 10 mmol / L).The SDBG,CV,IQR,PPGE and the frequency of hypoglycemia were compared between the second day after admission and one week after treatment.Using SPSS21.0 software for statistical analysis.Measurement data were expressed as mean ± standard deviation((?)±s),before and after treatment using paired t-test group,the count data expressed as a percentage,between groups using independent samples t-test,chi-square test;P <0.05 was considered statistically different.Results:1.The fasting blood glucose,2 h postprandial blood glucose,Hb A1 c,BMI,TC,TG,systolic blood pressure,diastolic blood pressure,course of disease were compared before treatment in the two groups.There was no significant difference in general parameters(P > 0.05).2.After treatment,the blood glucose levels of the two groups were significantly lower than those before treatment,the difference was statistically significant(p <0.05).After treatment,there was no significant difference except for blood glucose after lunch between the two groups.Blood glucose in experimental group was lower than that in control group after lunch,the difference was statistically significant(P <0.05).3.There was no significant difference in blood glucose fluctuation indexes(SDBG,CV,IQR,PPGE)between the two groups before treatment(p > 0.05).Except for the CV,the indexes in the control group had statistical difference after treatment.All the indexes in the experimental group were significantly different from those before treatment,and better than the control group(P < 0.05).4.No significant hypoglycemic events were detected in both groups before and after treatment(i.e.blood glucose was lower than 3.9 mmol / L or there were significant hypoglycemic symptoms).Conclusion:1.The decrease of blood glucose after lunch was more obvious after combined with sitagliptin.2.There was no difference in the coefficient of variation before and after insulin therapy alone,suggesting that the fluctuation of blood glucose between the day was still large.3.After combined with sitagliptin,the blood glucose fluctuation indexes of patients were significantly improved,which suggested that the combined therapy could significantly decrease blood glucose and also significantly reduce intra-day and inter-day blood glucose fluctuations.4.No significant hypoglycemic events were observed after combined with sitagliptin. |
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