| Background:In recent years,diabetes has become one of the global public health problems due to various reasons,such as social and economic development,lifestyle change and population aging.Type 2 diabetes is the most common type of diabetes,accounting for about 90%of the patients with diabetes.Its occurrence not only brings pain to the patients themselves,but also aggravates the economic burden on the country and the family.At present,the treatment methods of type 2 diabetes include medical nutrition,sports therapy,drug therapy,surgical treatment,etc.,and drug therapy is still the most common treatment method for most type 2 diabetes patients.With the deepening understanding of the etiology and pathogenesis of type 2 diabetes,hypoglycemic drugs with different mechanisms of action are being developed continuously,providing more and better choices for patients with type 2 diabetes.Dipeptide excitation peptidase-4(DPP-4)inhibitors have heterogeneity,as a new type of hypoglycemic drugs for type 2diabetes,have new hypoglycemic mechanism,definite hypoglycemic effect,however,in the clinical application process,it was found that the hypoglycemic effect of these drugs was significantly different in different type 2 diabetes patients.less adverse reaction and safety of higher advantages,more and more applied in clinical treatment,so the DPP-4 inhibitors of short-term curative effect and factors may affect its curative effect,can provide the basis for choosing drugs,develop better treatments,avoid improper choice of poor and hypoglycemic effect.Objective:In this paper,the short-term efficacy of DPP-4 inhibitors in patients with type 2diabetes and the relationship between DPP-4 inhibitors and relevant clinical indicators were explored,so that DPP-4 inhibitors can be better used in clinical treatment.Methods:This study collected clinical data of 200 patients with type 2 diabetes who were hospitalized in the Department of Endocrinology,the first hospital of Jilin University from January 2016 to January 2019.All patients had poor glycemic control in the original hypoglycemic drugs.On the basis of DPP-4 inhibitor treatment,116 patients taking sitagliptin and 84 patients taking vildagliptin.The general conditions of all patients included:gender,age,height,weight,course of diabetes,adverse reactions during medication and hypoglycemia events.Biochemical indicators include:glycated hemoglobin,C-peptide,triglycerides,cholesterol,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,creatinine,uric acid,fasting blood glucose values and 2-hour postprandial blood glucose values of 3 days before and after medication,body mass index=body weight(kg)/height squared(m~2),insulin resistance index=1.5+fasting blood glucose(mmol/L)×fasting C peptide(pmol/L)/2800,the mean of 3days fasting blood glucose values and 2-hour postprandial blood glucose values before and after medication and blood glucose decreased.Grouped according to different medications(sitagliptin,vildagliptin).Data table was established by using Microsoft Excel software,and statistical analysis was carried out by SPSS24.0 software.The normal distribution of measurement data was expressed in the form of mean±standard deviation,the measurement data between the two samples was compared by paired sample t test.The measurement data of the skewed distribution were expressed by the median(interquartile range),the measurement data between the two samples were compared by paired sample nonparametric test and independent sample nonparametric test.The multivariate linear stepwise regression analysis was used to analyze the factors affecting the blood glucose level of the patients.P<0.05 indicates that the difference was statistically significant.Results:1.The fasting blood glucose level of all patients before taking DPP-4 inhibitor was9.05±2.44mmol/L,the 2-hour postprandial blood glucose value was 12.47±2.65 mmol/L,and the fasting blood glucose value after taking DPP-4 inhibitor was 7.80±1.86 mmol/L,the 2-hour postprandial blood glucose value was 10.05±2.25 mmol/L,and compare the fasting blood glucose before and after taking the drug and the 2-hour postprandial blood glucose value,the difference was statistically significant(P<0.05);the fasting blood glucose level of patients in the sitagliptin group before taking medicine was8.87±2.34mmol/L,the 2-hour postprandial blood glucose level was 12.43±2.68mmol/L,and the fasting blood glucose level after taking sitagliptin was 7.45±1.61mmol/L.the 2-hour postprandial blood glucose level was 2.48±2.27 mmol/L,compare the fasting blood glucose before and after taking sitagliptin and the 2-hour postprandial blood glucose level,the difference was statistically significant(P<0.05);The fasting blood glucose level of patients in the vildagliptin group before taking medicine was 9.30±2.55mmol/L,the 2-hour postprandial blood glucose was 12.51±2.62 mmol/L,and the fasting blood glucose level after taking vildagliptin was 8.27±2.06 mmol/L,the 2-hour postprandial blood glucose value was 10.34±2.26 mmol/L,and compare the fasting blood glucose before and after taking vildagliptin and the 2-hour postprandial blood glucose levels,the difference was statistically significant(P<0.05).2.The decrease of fasting blood glucose was 0.98(0.28-2.13)mmol/L and 2-hour postprandial blood glucose was 2.17(0.93-3.86)mmol/L after taking DPP-4 inhibitors in all patients,compare the decrease in fasting blood glucose and the 2-hour postprandial blood glucose after taking the drug,the difference was statistically significant(P<0.05);in the sitagliptin group,fasting blood glucose decreased by 1.06(0.40-2.39)mmol/L after taking the drug,and the 2-hour postprandial blood glucose decreased by 2.13(1.23-4.06)mmol/L,compare the decrease in fasting blood glucose and the 2-hour postprandial blood glucose after taking sitagliptin,the difference was statistically significant(P<0.05);in the vildagliptin group,the fasting blood glucose decreased by 0.84(0.14-2.00)mmol/L after taking the drug,and the 2-hour postprandial blood glucose decreased by 2.16(0.60-3.62)mmol/L,compare the decrease in fasting blood glucose and the 2-hour postprandial blood glucose after taking vildagliptin,the difference was statistically significant(P<0.05).3.Multivariate linear stepwise regression analysis the factors which affects the reducing blood plasma capacity of DPP-4 inhibitors showed that fasting blood glucose levels before treatment and course of diabetes were factors influencing the decline of fasting blood glucose,the effect was positively correlated with fasting blood glucose level before treatment and negatively correlated with course of diabetes.the 2-hour postprandial blood glucose before treatment,triglyceride and course of diabetes were factors affecting the decline of 2-hour postprandial blood glucose,the effect of DPP-4inhibitors to reduce 2-hour postprandial blood glucose was positively correlated with the 2-hour postprandial blood glucose before medication,and negatively correlated with triglycerides and course of diabetes.4.According to the drug grouping,the fasting blood glucose decreased by 1.06(0.40-2.39)mmol/L in the sitagliptin group,in the vildagliptin group the fasting blood glucose decreased by 0.84(0.14-2.00)mmol/L,compare the decreased fasting blood glucose in the two groups after treatment,there was no statistical significant(P>0.05);the 2-hour postprandial blood glucose decreased by 2.13(1.23-4.06)mmol/L in the sitagliptin group,the 2-hour postprandial blood glucose decreased was 2.16(0.60-3.62)mmol/L in the vildagliptin group,compare the decreased 2-hour postprandial blood glucose in the two groups after treatment,there was no statistical significant(P>0.05).5.All patients had no significant adverse reactions and hypoglycemia events after taking DPP-4 inhibitors.Conclusion:1.DPP-4 inhibitors are effective in reducing fasting blood glucose and 2-hour postprandial blood glucose,and reducing the 2-hour postprandial blood glucose is more effective.2.The higher the fasting blood glucose level before treatment,the shorter the course of diabetes,the better the DPP-4 inhibitors reduces the fasting blood glucose.3.The higher the 2-hour postprandial blood glucose level,the lower the triglyceride and the shorter the course of diabetes,the better the DPP-4 inhibitors reduces the 2-hour postprandial blood glucose. |
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