Efficacy of dipeptidyl peptidase 4 inhibitor combined with insulin detemir in the treatment of type 2 diabetes mellitus with poor blood glucose control and its effects on blood glucose and oxidative stress indicators

ABSTRACT

Objective:

A total of 105 patients with poor blood glucose control after taking oral hypoglycemic drugs who received treatment between August 2017 and September 2019 were included in this study. They were randomly assigned to receive treatment with either ID and compound vitamins (control group, n = 53) or dipeptidyl peptidase 4 inhibitor sitagliptin and ID (study group, n = 52). After 3 months of treatment, the clinical efficacy was compared between the control and study groups. Before and after 3 months of treatment, blood glucose indexes [fasting plasma glucose, 2-hour postprandial blood glucose], glycosylated hemoglobin, islet β-cell function [homeostasis model assessment-beta and homeostasis model assessment of insulin resistance)], oxidative stress index [superoxide dismutase, glutathione peroxidase, lipid hydroperoxides, malondialdehyde were compared between the two groups. The incidence of hypoglycemia was also recorded in each group.

After 3 months of treatment, total effective rate in the study group was significantly higher than that in the control group [92.31% (48/52) vs. 77.36% (41/53), χ2 = 4.541, P < 0.05]. After 3 months of treatment, fasting plasma glucose, 2-hour postprandial blood glucose, glycosylated hemoglobin, homeostasis model assessment of insulin resistance, lipid hydroperoxide and malondialdehyde levels in each group were significantly decreased, homeostasis model assessment-beta, superoxide dismutase and glutathione peroxidase levels were significantly increased compared with before treatment (all P < 0.05). There were significant significances in these indexes measured concurrently between the study and control groups ( t = 2.902, 3.539, 5.215, 7.313, 6.269, 4.475, 6.050, 3.323, 5.375, all P < 0.05). During the treatment, the incidence of hypoglycemia in the study group was significantly lower than that in the control group [0.00% (0/52) vs. 11.54% (6/53), χ2 = 4.319, P < 0.05].

Dipeptidyl peptidase 4 inhibitor combined with insulin detemir is highly effective for type 2 diabetes mellitus with poor blood glucose control. It can effectively control blood glucose level, improve oxidative stress reaction and is highly safe. Therefore, this treatment method is of good application value.