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Received:June 08, 2023 Published Online:December 20, 2023
Received:June 08, 2023 Published Online:December 20, 2023
中文摘要: 目的 探讨对黎明现象频发老年2型糖尿病（T2DM）患者睡前加服二甲双胍片的疗效及对胰岛细胞功能的影响。
方法选取2018年5月至2021年4月于滁州市第一人民医院就诊的老年T2DM患者160例，随机分为对照组（n=80）和观察组（n=80），对照组给予门冬胰岛素强化治疗，观察组在此基础上睡前加服二甲双胍片500 mg。两组均连续治疗12周，对比两组患者治疗前后血糖变化、胰岛细胞功能变化、黎明现象发生率。采用ORACLE 10 g工具构建随机行走模型评价睡前加服二甲双胍片对黎明现象频发T2DM患者胰岛细胞功能的影响。
结果 治疗后，对照组空腹血糖（FPG）、餐后2 h血糖（2hPG）及变异系数（CV）较治疗前降低，观察组FPG、2hPG、睡前血糖及CV较治疗前降低（P<0.05）。且观察组治疗后FPG、2hPG及CV低于对照组（P<0.05）。两组空腹C肽（FC-P）、餐后2 h C肽（2hPC-P）、稳态模式评估法胰岛素分泌指数(HOMA-β)较治疗前增高，胰岛素抵抗指数（HOMA-IR）较治疗前降低（P<0.05），且观察组治疗后FC-P、2hPC-P、HOMA-β、HOMA-IR改善效果优于对照组（P<0.05）。观察组黎明现象发生率为30.00%（18/60），低于对照组的65.00%（39/60），差异有统计学意义（χ2=14.737，P<0.01）。随机行走模型评价结果显示，观察组患者胰岛细胞功能改善效果优于对照组。
结论 在短期强化胰岛素治疗的基础上，睡前加服二甲双胍片可有效控制黎明现象频发T2DM患者的血糖水平，改善胰岛细胞功能。
Abstract:Objective To investigate the effect of metformin tablets before bedtime and its effect on islet cell function in elderly type 2 diabetes mellitus (T2DM) patients with frequent dawn phenomenon.
Methods A total of 160 elderly patients with T2DM in The First People's Hospital of Chuzhou from May 2018 to April 2021 were selected. They were divided into the control group (n=80) and the observation group (n=80) randomly. The control group was given intensive treatment with insulin aspart, while the observation group was given an additional 500 mg of before bedtime metformin tablets on this basis. Both groups were treat contimuously for 12 weeks. The changes in blood glucose, islet cell function, dawn phenomenon before and after treatment were compared. ORACLE 10 g tool was used to construct a random walking model for evaluating the effect of taking metformin tablets before bedtime on the function of pancreatic islet cells in elderly T2DM patients with frequent dawn phenomenon.
Results After treatment, fasting plasma glucose (FPG), 2 h postprandial glucose (2hPG) and coefficient of variation (CV) in the control group reduced, while FPG, 2hPG, blood glucose before bedtime and CV in the observation group reduced (P<0.05). The FPG, 2hPG and CV in the observation group were lower than those in the control group (P<0.05). Compared with those before treatment, fasting C-Peptide (FC-P), 2 h postprandial C-Peptide (2hPC-P), HOMA-β decreased, and HOMA-IR increased in two groups (P<0.05), and the improvement effect in observation group were better than the control group (P<0.05). The incidence of dawn phenomenon in the observation group was 30.00% (18/60), lower than 65.00% (39/60) in the control group (χ2=14.737, P<0.01). The evaluation results of random walking model showed that the improvement effect of islet cell function in the observation group was better than that in the control group.
Conclusion On the basis of shorttime intensive insulin therapy, taking metformin tablets before bedtime can effectively control the blood sugar level of elderly T2DM patients with frequent dawn phenomenon and improve the function of islet cells.
keywords: Type 2 diabetes mellitus Dawn phenomenon Metformin Islet cells Random walk model Insulin aspart
文章编号： 中图分类号：R587.1 文献标志码：A
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