Clinical observation of sitagliptin combined with insulin aspart 30 with in the treatment of secondary failure of sulphonylurea in type 2 diabetes mellitus / 中国医师进修杂志

ABSTRACT

Objective To observe the effect of sitagliptin combined with insulin aspart 30 in the treatment of secondary failure of sulphonylurea in type 2 diabetes mellitus. Methods Fifty-six cases were divided into group A and group B in random block design, with 28 cases of each group. The patients in group A was treated with sitagliptin combined with insulin aspart 30, while the patients in group B was given subcutaneous injection of insulin aspart 30R. All patients were treated for 12 weeks. Fasting plasma glucose(FPG), 2-hour postprandial plasma glucose(2 hPG), glycosylated hemeglobin(HbA1c), insulin secretion index (HOMA-β), body mass index (BMI), and incidence of low blood glucose before and after treatment were compared. Results Compared with that in group B, FPG [(5.61 ± 1.14) mmol/L vs. (7.8 ± 1.22) mmol/L], 2 hPG [(7.62 ± 1.35) mmol/L vs(9.72 ± 1.41) mmol/L] and HbA1c [(7.11 ± 0.83)%vs.(8.32 ± 1.04)%] in group A had a significant decrease;HOMA-β[(50.31 ± 5.12) vs. (41.86 ± 4.53)] of group A was higher than that of group B (Pdose of insulin [(25.84 ± 3.42) U/d vs. (36.37 ± 5.41) U/d] and the rate of hypoglycemia [7.1%(2/28) vs. 21.4%(6/28)] in group A was lower than that in group B (P<0.05) with statistical significance. Conclusions Sitagliptin combined with insulin aspart 30 in the treatment of secondary failure of sulphonylurea in type 2 diabetes mellitus can effectively control blood glucose, improve islet βcell function, reduce the insulin dosage, and reduce the risk of weight gain and hypoglycemia.