Clinical observation of linagliptin combined with insulin in the treatment of fragility diabetes complicated with early diabetic nephropathy

Abstract

Objective To evaluate the clinical effect of linagliptin combined with insulin in the treatment of fragile diabetes complicated with early diabetic nephropathy. Methods From January 2014 to May 2017, 98 patients with fragile diabetes complicated with early diabetic nephropathy were divided into two groups according to 1∶1 randomized, double-blind group. On the basis of insulin and benazepril, they were divided into oral linagliptin group and oral placebo control group. The course of treatment was 12 weeks. General data of age, sex, course of disease, height, weight, systolic and diastolic blood pressure, triglyceride, total cholesterol, blood urea nitrogen, cereatinine, uric acid and microalbuminuria were collected. After the subjects were enrolled in the group, self-blood glucose monitoring was performed to record their blood glucose control and fluctuation. The patients were followed up at baseline, 4, 8 and 12 weeks after treatment. Meanwhile, the changes of insulin dosage, blood sugar, serum C-peptide, glucagon, GLP-1, GIP and microalbuminuria levels were collected before and after treatment. Results After 12 weeks of treatment, the average blood sugar, FBG and PPG in the linagliptin group were lower than those before treatment and after treatment in the control group (P 0.05). The levels of glucagon and GIP in the linagliptin group 30 minutes after meal were lower than those before and after treatment(P<0.01), while the levels of GLP-1 (60 minutes) were higher than those before treatment and in the control group(P<0.01). Conclusions Combination of linagliptin and insulin in the treatment of fragile diabetes complicated with early diabetic nephropathy can achieve the target of HbA1c, decrease the fluctuation of blood sugar, decrease the dosage of insulin and the occurrence of hypoglycemia, without increasing risk of renal impairment. Key words: Diabetes Mellitus; Diabetic Nephropathies; Linagliptin; Insulin