Clinical Efficacy And Safety Of Dalglishen Combined With Insulin Enhancement In The Treatment Of Obesity Type 2 Diabetes Mellitus

Objective Explore the clinical efficacy and safety of dapagliflozin combined with intensive insulin therapy for obesity Type 2 diabetes mellitus.And confirm the using of dapagliflozin combined with intensive insulin can reach the standard of blood sugar as soon as possible and reduce the dosage of insulin when it meets the standard,and can improve the patients’ sensitivity to insulin.Explore the effect of the treatment on the lipid metabolism,uric acid metabolism,body fat and other indexes of the obese patients,and provide a theoretical reference for this type of patients clinically.Methods 130 patients with obese Type 2 diabetes treated in our hospital from December 2018 to April 2019 were selected as the study subjects.The numerical table was grouped randomly.There were 65 cases in the control group and 65 cases in the study group.Both groups were given the guidance of diet combined with exercise.The study group was given 10mg of dapagliflozin combined with intensive insulin therapy and the control group was given intensive insulin therapy.The two groups were treated 12 weeks.During this time,the peripheral blood glucose was detected by Roche excellent blood glucose meter and used the Beckman AU5800 biochemical instrument to test the experimental indexes.Results(1)In the study group,TG was decreased while HDL-C and LDL-C level were increased compared with that in the former case.And the difference between the control group and the study group was statistically significant,P<0.05.(2)The excretion of urine uric acid in the study group was significantly increased and the level of blood uric acid was decreased compared with that in the former case.And the difference between the control group and the study group was statistically significant,P<0.05.(3)The treatment compared the waist circumference,weight and BMI of the two groups before and after the treatment.After the treatment,there was no significant change in each index of the control group,P>0.05.Compared with the former treatment,all indexes in the study group showed significant improvement,P<0.05.(4)When the study group was on an empty stomach,the level of insulin and the function index of islet B cell increased,while the resistance index of the insulin in the study group decreased,P<0.05.There was no significant improvement in the control group,P>0.05.(5)After the treatment,fasting blood glucose,2-hour postpranemic blood glucose and glycosylated hemoglobin in the two groups were much better than before,P<0.05 in the control group and P<0.001 in the study group,all showing the statistical differences.(6)Compared with the time of blood glucose reaching the standard,the time in the study group was much lower than that in the control group.And the daily insulin dosage in the study group was significantly lower than that in the control group,the difference was statistically significant,P<0.01.(7)During the treatment,there was no serious hypoglycemia in the control group;there was no significant difference in the incidence of urinary tract infection between the two groups.Conclusion Dapagliflozin combined with intensive insulin therapy is not working for controlling the blood sugar,especially for the patients with obese type 2 diabetic,but can improve the function of islets of langerhans significantly.The early reaching of blood sugar standard and the reduction of insulin dosage can significantly reduce the weight of obese patients’ bodies,improve the metabolism level of lipid and uric acid,and achieve a low number of the adverse reactions such as hypoglycemia and urinary tract infection,so the clinical application is safe.