Clinical effect comparison between the short-term intensive insulin and metformin combined with saxagliptin in the treatment of early type 2 diabetes

Objective: To compare the clinical effects between the short-term intensive insulin and metformin combined with saxagliptin in the treatment of early type 2 diabetes.Methods: One hundred and two early type 2 diabetes patients were randomly divided into the short-term intensive insulin therapy group(short-term group) and saxagliptin combined with metformin therapy group(combination group) according to the random number table method(51 cases each group).Before treatment and after 12 weeks of treatment,the levels of fasting plasma glucose(FPG),2 h postprandial glucose(2hPG),glycosylated hemoglobin(HbA1c),fasting C-peptide(FC-P),postprandial 2 h C peptide (2hC-P),fat adiponectin(ADP) and glucagon(GC) in two groups were detected,the homeostasis model insulin secretion index(HOMA-β) and insulin resistance index(HOMA-IR) in two groups were calculated,and the blood glucose standard time and hypoglycemia incidence in two groups were recorded.Results: After treatment,the levels of FPG,2hPG and HbA1c in two groups significantly decreased compared with before treatment(P<0.01),the level of HbA1c in short-term group was significantly lower than that in combination group(P<0.01),and the differences of the levels of FPG and 2hPG between two groups were not statistically significant(P>0.05).After treatment,the FC-P,2hC-P,HOMA-β and HOMA-IR in two groups were significantly improved compared with before treatment(P<0.05),and the differences of the levels of FC-P,2hC-P,HOMA-β and HOMA-IR between two groups were not statistically significant(P>0.05).The levels of GC and body mass index in combination group after treatment were significantly lower than those before treatment(P<0.01),and the differences of the levels of GC and body mass index in short-term group between before and after treatment were not statistically significant(P>0.05).After treatment,the levels of ADP in two groups significantly increased compared with before treatment(P<0.01),which in combination group was more significant than that in short-term group(P<0.01).The difference of blood glucose standard time between two groups was not statistically significant(P>0.05),and the incidence rate of hypoglycemia in short-term group was significantly higher than that in combination group(P<0.01).Conclusions: The short-term intensive insulin and saxagliptin combined with metformin in treating the early type 2 diabetes can control the level of blood glucose and improve the islet β-cell function of patients.The short-term intensive insulin can obviously reduce the HbA1c level,and the saxagliptin combined with metformin can significantly inhibit the GC level,increase the ADP level,decrease the incidence rate of hypoglycemia,and does not affect the body weight of patients.