| BackgroundSome patients clinically single oral drug treatment of poor control of blood sugar often,reasonable combination,to achieve the purpose of control blood sugar levels to reduce complications at home and abroad combined with metformin dipeptide base peptidase 4(DPP-4)inhibitors as the preferred treatment for glucose transporters loaded sodium 2 a(SGLT-2)inhibitors,it's by reducing renal tubular reabsorption of glucose to increase the excretion of renal glucose play hypoglycemic effect,but for metformin joint(SGLT-2)inhibitors,blood glucose and the relevant effects on the metabolic indices of clinical research.ObjectiveTo explore the diagnosis and treatment of metformin alone in poor glycemic control in patients with type 2 diabetes,respectively,with Empagliflozin(SGLT-2 inhibitor),Sitagliptin(DPP 4 inhibitors),after observing Empagliflozin in combination with metformin treatment effect of glycemic control in patients with type 2 diabetes and related metabolic index changes,assessment of Empagliflozin t effectiveness of clinical application and potential risk.MethodsScreening of 29 cases after 1 month of metformin alone still poorly controlled blood glucose in patients with type 2 diabetes,according to random number table method is divided into:(1)The observation group of 13 cases: metformin combined therapy with Empagliflozin the glucose metabolism of blood lipid and other related indexes were observed.(2)The control group 16 cases: joint Sitagliptin treatment observed in patients with blood sugar metabolism of blood lipid and other related indicators allow patients to continue to accept any lipid-lowering and blood pressure drugs before the start of the study,comparison before and after treatment to observe the way the contrast between observation group and the control way within the way patient: 1.The change level of blood glucose was as follows: fasting blood glucose(FBG)2h Postprandial blood glucose(2h PG)HbA1c.2.Function of islet cells: fasting c-peptide(FCP)2h post-meal c-peptide(2h PCP)fasting insulin(FINS);3.Blood pressure :[systolic blood pressure(SBP)diastolic blood pressure(DBP)];4.Blood lipid :[high-density lipoprotein(HDL-C)low-density lipoprotein(LDL-C)cholesterol(TC)triglyceride(TG)];Body mass index: 5.BMI;Urine sodium urine sugar 24h;6.Other indicators: routine urine,liver function: [transaminase,bilirubin,etc.],and the incidence of hypoglycemia during oral administration was statistically analyzed.Results(1)Before treatment,there was no statistically significant difference between the observation group and the control group in terms of gender,age,blood pressure,blood lipid and other metabolic indicators(P>0.05).(2)Comparison of metabolic indexes in the observation group before and after treatment,the control group before and after treatment,and the observation group and the control group after treatment:(1)Comparison between the two groups: fasting blood glucose(FBG),blood glucose(2h PG)and HbA1c(HbA1c)were all lower than those before treatment,with no statistically significant difference(P<0.05).No significant difference was found between the two groups(P>0.05).(2)Comparison between the two groups: fasting c-peptide(FCP)and 2h post-meal c-peptide(2h PCP)were both improved compared with those before treatment,with statistically significant differences(P<0.05).After treatment,the FINS level of both groups was lower than that before treatment,with statistically significant differences(P<0.05).2.Comparison between the two groups: there was no significant difference in fasting c-peptide(FCP)and 2h post-meal c-peptide(2h PCP)(P>0.05).The values of the FINS level in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).(3)Comparison between the two groups: the SBD observation group was lower than that before treatment,and the difference was statistically significant(P<0.05);no significant reduction was observed in the control group(P>0.05);both the DBP observation group and the control group were less statistically significant than that before treatment(P>0.05).2.Comparison between the two groups: the SBP observation group was lower than the control group,and the difference was statistically significant(P<0.05).The comparison between the two groups of DBP was not statistically significant(P>0.05).(4)Body mass change: 1.Comparison between the two groups: BMI in both groups decreased compared with that before treatment,and the difference was statistically significant(P<0.05).2.Comparison between the two groups: the BMI of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).(5)Comparison between the two groups: the TC observation group showed no statistically significant difference(P>0.05),while the control group showed statistically significant difference(P<0.05).The TG observation group was lower than that before treatment,and the difference was statistically significant(P<0.05).The control group had no significant change compared with that before treatment,and the difference was not statistically significant(P>0.05).The observation group of HLD-C was higher than that before treatment,with statistically significant difference(P<0.05),while the control group showed no significant change compared with that before treatment,with no statistically significant difference(P>0.05).The LDL-C observation group showed no significant change compared with that before treatment,and the difference was not statistically significant(P>0.05),while the control group showed a decrease compared with that before treatment,and the difference was statistically significant(P<0.05).2.Comparison between the two groups: TC observation group was higher than the control group,and the difference between groups was statistically significant(P<0.05).The TG observation group decreased compared with the control group,and the difference between groups was statistically significant(P<0.05).The observation group of HLD-C was higher than the control group,and the difference between the groups was statistically significant(P<0.05).LDL-C in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).(3)Changes in other indicators: changes in urine routine and liver function:The positive rate of leucocyte and liver function index of routine urine microscopy: the positive rate of observation group after treatment was significantly different from that of control group(P<0.05).There was no abnormal liver function in the two groups,and the difference was not significant(P>0.05).(4)Incidence of hypoglycemia:No hypoglycemia or hypotension events occurred in the two groups after treatment,with no significant difference(P>0.05).Conclusions(1)Metformin combined with Empagliflozin in the treatment of type 2 diabetes can effectively improve the blood glucose level of patients,and there is no significant difference in the hypoglycemic effect of metformin combined with Sitagliptin.(2)Metformin combined with Empagliflozin had the effect of reducing blood pressure and weight compared with metformin combined with Sitagliptin in the treatment of type 2 diabetes,and no hypotension events were found.(3)Metformin combined with Empagliflozin in the treatment of type 2 diabetes may increase the risk of urinary tract infection in patients. |
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