第二临床医学院知识库

目的：研究使用达格列净治疗的2型糖尿病患者的治疗结果（糖化血红蛋白HbA1c，空腹血糖FPG，体重）的变化。同时探讨达格列净治疗2型糖尿病患者的安全性。 方法：选取2017年5月至2018年2月于兰州大学第二医院内分泌代谢二科的住院及门诊就诊的2型糖尿病患者30例为本研究的研究对象，其中男性19例，女性11例，平均年龄 57.23±10.33岁，糖化血红蛋白8.36±1.19%。给予达格列净10mg持续时间12周的药物治疗。其中3例因依从性较差退出试验。共完成27例，均符合WHO（1999）糖尿病诊断标准。所有受试者在原有降糖药物降糖基础上，加用每日晨口服达格列净10mg（餐前餐后均可），同时所有受试者配合进行运动治疗及饮食控制，疗程持续时间12周后，评价受试者糖化血红蛋白（HbA1c）、空腹血糖（FPG）、体重（BW）与治疗前的基线相比的平均变化情况。结果：1. 达格列净10mg持续治疗12周，可有效控制2型糖尿病患者糖化血红蛋白（HbA1c）情况。治疗后受试者平均糖化血红蛋白（HbA1c）7.70±1.02%，与治疗前相比糖化血红蛋白（HbA1c）平均下降0.66±0.31%，P<0.05，有统计学差异。同时治疗后糖化血红蛋白（HbA1c）≤7%的人数百分占所有研究对象的29.63%。2. 达格列净10mg持续治疗12周，可有效控制2型糖尿病患者空腹血糖（FPG）情况。治疗后受试者空腹血糖（FPG）8.42±1.86mmol/L，与治疗前相比空腹血糖（FPG）平均下降1.77±1.15mmol/L，P<0.05，有统计学差异。3. 达格列净10mg持续治疗12周，可有效控制2型糖尿病患者体重（BW）情况。治疗后受试者平均体重74.36±11.59kg，与治疗前相比体重平均下降1.67±0.68 kg，P<0.05，有统计学差异。4. 在整个研究过程中未观察到受试者出现严重低血糖、夜间低血糖、泌尿系肿瘤、药物过敏等严重不良反应的发生。出现的不良反应占所有研究对象的3.7%，可经过对症治疗后或自行缓解。结论：通过对T2DM患者达格列净10mg持续12周应用结果分析，在服用达格列净后糖化血红蛋白、空腹血糖、体重均有所改善，同时研究过程中未出现严重低血糖及泌尿系感染等药物副作用。这些研究结果表明，钠-葡萄糖协同转运蛋白2抑制剂达格列净对2型糖尿病的治疗和管理有效且耐受性良好。

Objective: To study the changes in the outcome of treatment (types of hemoglobin HbA1c, fasting plasma glucose FPG, body weight) in patients with type 2 diabetes treated with dapagliflozin. At the same time, the safety of dapagliflozin in treating type 2 diabetes was discussed. Methods: Thirty patients with type 2 diabetes who were admitted to the Department of Endocrinology and Metabolism of the Second Hospital of Lanzhou University from May 2017 to February 2018 were selected as the study subjects, including 19 males and 11 females. 57.23±10.33 years old, HbA1c 8.36±1.19%. Dalgliflozin was given 10 mg for 12 weeks of drug treatment. Three of them withdrew because of poor compliance. A total of 27 cases were completed and all met the WHO (1999) diagnostic criteria for diabetes. All subjects were on the basis of the original hypoglycemic agents hypoglycemic, plus daily dapagliflozin 10mg (before meals can be), and all subjects with exercise therapy and diet control, treatment duration after 12 weeks, subjects were evaluated for the average change in HbA1c, FPG, and BW compared to baseline before treatment.Result:1. Dapagliflozin 10 mg for 12 weeks of continuous treatment can effectively control the status of HbA1c in patients with type 2 diabetes. After treatment, the average HbA1c of the subjects was 7.70±1.02%. Compared with before treatment, the HbA1c decreased by 0.66±0.31%, P<0.05, which was significantly different. At the same time, the percentage of the patients with glycosylated hemoglobin (HbA1c) ≤ 7% after treatment was 29.63% of all subjects.    2. Dalgliflozin 10 mg for 12 weeks of continuous treatment can effectively control fasting plasma glucose (FPG) in patients with type 2 diabetes. After treatment, the fasting plasma glucose (FPG) of the subjects was 8.42±1.86 mmol/L, which was an average decrease of 1.77±1.15 mmol/L compared with pre-treatment fasting plasma glucose (FPG), P<0.05, with statistical difference.3. Dapagliflozin 10mg for 12 weeks of continuous treatment can effectively control the body weight（BW）of patients with type 2 diabetes. After treatment, the average body weight of the subjects was 74.36±11.59kg, and the average weight of the subjects before treatment was decreased by 1.67±0.68kg, P<0.05. There was a statistically significant difference.4. No serious adverse reactions such as severe hypoglycemia, nocturnal hypoglycemia, urinary tumor, and drug allergy were observed during the entire study. The adverse reactions that occurred accounted for 3.7% of all subjects and could be relieved after symptomatic treatment.Conclusions: By analyzing the results of applying dapagliflozin 10 mg for 12 weeks in T2DM patients, HbA1c, fasting plasma glucose, and body weight were improved after taking dapagliflozin, and there were no serious side effects such as hypoglycemia and urinary tract infection during the study. . These findings suggest that the sodium-glucose cotransporter 2 inhibitor dapagliflozin is effective and well-tolerated for the treatment and management of type 2 diabetes.