Effect Observation of Itagliptin Combined with Large -dose Insulin on Poorly Controlled Type 2 Diabetes Patients

doi:10.3969/j.issn.1004-5775.2015.07.012

Abstract：Objective To observe the effect of sitagliptin combined with large-dose insulin on poorly controlled type 2 diabetes pa-tients.Methods 80 patients selected with a single-use insulin ( aspart insulin and glargine) , a total of daily insulin more than 50u and a HbA1c more than 8%were randomly divided into two groups:insulin and sitagliptin group, and insulin group.The levels of body mass index (BMI), fast blood glucose (FBG), 2 hour postprandial blood glucose (2hPG), HbA1c, maximum and minimum blood glucose difference (ΔMMBG) , mean postprandial maximum blood glucose( MPMG) , the amount of insulin and the frequency of hypoglycemia be-fore and after the treatment of the two groups were observed.Results After 12 weeks treatment, the levels of FBG,2hPG and HbA1c sig-nificantly decreased (P<0.05).However, there was no significant difference between the two groups (P>0.05).Compared with insulin group, the levels ofΔMMBG and MPMG, and the amount of insulin significantly decreased in insulin and sitagliptin group after 12 weeks treatment (P<0.05), and there was statistical difference between the two groups (P<0.05).Before and after the treatment of insulin and sitagliptin group, BMI did not change significantly.However, BMI increased in insulin group compared with before treatment.After treat-ment, there was statistical significance in BMI between the two groups (P<0.05).Compared with insulin group, the frequency of hypogly-cemia significantly reduced in insulin and sitagliptin group ( P<0.05 ) , and there was statistical difference between the two groups ( P<0.05).Conclusion Sitagliptin combined with insulin could control the blood glucose of the patients who present with worse efficacy only with the treatment of large-dose insulin.And the treatment can decrease insulin dose without increasing the weight, and also can reduce fluctuations in blood glucose and hypoglycemia.