Basal Insulin Combined with Dipeptidyl Peptidase-4 Inhibitors in Treating Type II Diabetes Clinical Observation

Objective:To explore the clinical effects of basal insulin(Insulin Glargine,Product Name:Lantus,By:Sanofi-Aventis)combined with Dipeptidyl peptidase-4 inhibitors(Phosphate Sitagliptin,product name:Propharm,By Merck Sharp Dohme,MSD)in treating type Ⅱ diabetes without good blood glucose level control by only giving basal insulin.Method:120 cases of type Ⅱ diabetes patients which were treated only with basal insulin,with body mass index(BMI)≥ 26 and not well controlled blood glucose level were randomized into two groups:(Insulin Glargine+Sitagliptin group,60 cases),in which Sitagliptin was orally taken at a dosage of 100 mg/d besides applying of Insulin Glargine and the does of Insulin Glargine applied was adjusted according to the patients’blood glucose levels;Insulin Glargine group(60 cases),for which applying of Insulin Glargine was continued.The BMI,fasting blood glucose(FBG),2 h postprandial blood glucose(2 h PG),Glycosylated hemoglobin(HbA1C)and the changes in applying does of Insulin Glargine were observed 8 and 12 weeks after treatment.Result:The blood glucose and HbA1C levels decreased in both groups 8 and 12 weeks later.8 weeks after treatment,the BMI of patients in Insulin Glargine group increased,and the BMI in Insulin Glargine+Sitagliptin group showed insignificant increase.The differences in BMI changed obtained at the same time point between the two groups were statistically significant,and the differences in BMI changes prior to and after treatment within the Insulin Glargine group were statistically significant(P 0.05 or P 0.01).On the 8th week,the applying dosage of Insulin Glargine in Insulin Glargine+Sitagliptin group decreased while the applying dosage in Sitagliptin group increased. On the 12th week,the applying dosage of Insulin Glargine in Insulin Glargine+Sitagliptin group decreased further more,the differences at the same time point between the two groups and the differences prior to and after treatment within the both groups were statistically significant(P 0.05 or P 0.01). Conclusion:Combining Sitagliptin with Insulin Glargine,better control in blood glucose level could be obtained in type Ⅱ diabetes without good blood glucose level control by only giving basal insulin.Besides,the applying does of Insulin Glargin decreases and the blood glucose level is under better control,which decreased the occurrence of Hypoglycemia,hence,treating type Ⅱ diabetes by combining Sitagliptin with Insulin Glargine is safe and effective.