Efficacy of SGLT-2 inhibitors and DPP-4 inhibitors combined with insulin in the treatment of patients with type 2 diabetes mellitus
Huang Liangzhi
Chen Ting
Wu Liwen
Abstract：Objective To explore the clinical efficacy of dipeptidyl peptidase-4(DPP-4)inhibitors and sodium glucose cotrans-porter-2(SGLT-2)inhibitors,respectively,in combination with insulin in the treatment of diabetes mellitus.Methods A total of 126 patients with type 2 diabetes mellitus admitted to the First Hospital of Nanping City from January 2022 to January 2025 were retro-spectively selected and divided into the SGLT-2 inhibitor group(63 cases)and the DPP-4 inhibitor group(63 cases)based on different treatment regimens.The SGLT-2 inhibitor group received dapagliflozin combined with insulin therapy,while the DPP-4 inhibitor group received sitagliptin combined with insulin therapy.The glucose metabolism indicators,pancreatic islet function indicators,clinical effi-cacy and the incidence of adverse reactions before and after treatment were compared between the two groups.Results The compari-son of the total effective rates between the two groups showed no statistically significant difference(92.06%(58/63)vs 90.48%(57/63),χ2=0.100,P>0.05).After treatment,the levels of 2-hour postprandial blood glucose,fasting blood glucose and glycated hemoglobin in the SGLT-2 inhibitor group((8.26±0.72)mmol·L-1,(5.64±0.57)mmol·L-1,(6.41±0.63)%,respectively)were all lower than those in the DPP-4 inhibitor group((9.17±0.86)mmol·L-1,(6.31±0.54)mmol·L-1,(6.83±0.72)%,respectively)(t=6.437,6.774,3.481,all P<0.05).After treatment,the insulin resistance index in the SGLT-2 inhibitor group(3.16±0.62)was higher than that in the DPP-4 inhibitor group(2.51±0.58),and the pancreatic β-cell function index in the SGLT-2 inhibitor group(50.42±8.09)was lower than that in the DPP-4 inhibitor group(56.07±8.12)(t=6.079,3.912,both P<0.05).Safety analysis showed that the overall incidence of adverse reactions was comparable between the two groups,with no statistically significant difference(11.11%(7/63)vs 9.52%(6/63),χ2=0.086,P>0.05).Conclusion The combination of SGLT-2 inhibitors and insulin has a better hypoglycemic effect,while DPP-4 inhibitors have a bet-ter advantage in improving pancreatic islet function.The efficacy and safety of both groups are similar,and clinical selection should be based on individualized treatment needs of patients.
Keywords：Sodium glucose cotransporter-2 inhibitorDipeptidyl peptidase-4 inhibitorDiabetes mellitusClinical efficacyInsulin
Publication Date：2025-09-25
Online Publishing Date：2025-10-10(First online date of this platform, not the publication date of the document)
Pages：4( 1038-1041 )