Efficacy And Security Of Sitagliptin In Combination With Insulin Detemir And Metformin In Type 2 Diabetes

Objective To investigate the clinical efficacy and safety of sitagliptin in combination with insulin detemir and metformin in type 2 diabetes.Methods We choose 60 cases patients with type 2 diabetes(T2DM)who take oral stable doses of metformin(≥1 500 mg/day) in combination with once-daily insulin detemir at least for 3 months and their blood glucose is still not up to standard. The choosed patients were randomly assigned to experimental and control groups.The experimental group added in sitagliptin(100 mg/pill),and the control group added in repaglinide(0.5mg/pill) 15-30 minutes before meals. During the treatment period,all choosed patients with diabetic standard caloric diet and exercise as a basis for the treatment.We treat 48 weeks,Self-controlled method to observe the changes of fasting plasma glucose(FBG),2 hours postprandial plasma glucose(2hPG), glycosylated hemoglobin(HbAlc), HOMA-IR,HOMA-β, FCP(fasting C-peptide),2h-CP(2 hours postprandial C-peptide), body mass index(BMI), blood pressure(BP), blood lipid and other indicators.Results1、Between the two groups before and after treatment, and the general situation between the two groupsAfter treatment: in the control group BMI, DBP, SBP showed no obvious change, there was no significant difference;in the experimental group BMI, DBP decreased, the difference was not statistically significant, SBP decreased significantly, the difference wasstatistically significant(P<0.05). After treatment, the experimental group than the control group in BMI, DBP decreased, the difference was not statistically significant, SBP decreased significantly, the difference was statistically significant(P<0.05).2、Between the two groups before and after treatment, and HbAlc、blood glucose between the two groups.After treatment: the control group FBG, 2hPG, HbAlc decreased, the difference was statistically significant(P<0.05, FBG); the experimental group, 2hPG, HbAlc decreased,the difference was statistically significant,(P<0.05). After treatment of FBG, 2hPG, HbAlc have no statistical significance difference between groups.3 、 Between the two groups before and after treatment, and FCP, 2h-CP, HOMA-IR,HOMA- β between the two groups.After treatment: the control group HOMA-IR decreased, FCP, 2hCP, HOMA- βincreased, but the difference was not statistically significant; the experimental group HOMA-IR, FCP, 2hCP decreased significantly and HOMA- β increased significantly, the difference was statistically significant(P<0.05); after treatment FCP, 2hCP and HOMA-β in increased in the experimental group more than in the control group significantly,HOMA-IR decreased significantly, the difference was statistically significant(P<0.05).4、Between the two groups before and after treatment, and blood lipid between the two groups.After treatment: the control group TG, LDL-C, TC, and HDL-C changed, there was no significant difference between the experimental group; TG, TC, LDL-C decreased significantly, HDL-C increased significantly, the difference was statistically significant(P<0.05); after treatment between two groups: TG, TC, LDL-C in the experimental group decreased more than in the control group significantly, HDL-C increased significantly, the differences were statistically significant(P<0.05).5、Safety: In the control group of 4 patients with symptoms of hypoglycemia, expressed as palpitation, sweating, no consciousness disorder of severe hypoglycemic events, after eating relieved in the course of the study; no hypoglycemic events in the experimental group.Conclusions The combination of insulin detemir, sitagliptin and metformin couldeffectively control blood glucose;significantly improve β-cell functionin;reduce weight in T2 DM patients and with a low rate of hypoglycaemia;Can promote lipid metabolism...