司美格鲁肽联合达格列净对二甲双胍治疗后病情控制不佳的老年2型糖尿病患者SOD、CAT、2hPBG水平的影响

The Effects of Semaglutide Combined with Dapagliflozin on SOD, CAT, and 2hPBG Levels in Elderly Patients with Type 2 Diabetes Mellitus Whose Conditions Were Not Well Controlled by Metformin

摘要: 目的：评估对于实施二甲双胍治疗后病情控制欠佳的老年2型糖尿病病人中，再结合司美格鲁肽、达格列净治疗的成效以及对病人过氧化氢酶(CAT)、超氧化物歧化酶(SOD)、餐后2 h血糖(2hPBG)水平的影响。方法：抽选病例65例，研究时间选自2024年1月~2025年1月，将其以随机数字表法划分为2个小组，即对照组(n = 32，接受达格列净治疗)和观察组(n = 33，再结合司美格鲁肽治疗)，评估2组的整体治疗成效及不良反应占比情况。结果：经合理处理后，两个月血糖、2hPBG和HbAlc指数均优于正常组(P < 0.05)。在FINS，HOMA-IR，HOMA-β三个维度上，上述两个维度的水平都有下降趋势，而后者则明显高于对照组(P < 0.05)。与对照组相比，实验组MDA和ROS水平明显降低，而CAT、SOD含量明显高于对照组(P < 0.05)。药物副作用发生的几率比对照小，分别为9.09%和6.25% (χ² = 0.185, P = 0.667)。结论：对接受二甲双胍治疗后病情控制不良的老年2型糖尿病患者而言，同时予以司美格鲁肽和达格列净治疗，更具安全性和有效性。

Abstract: Objective: To evaluate the efficacy of combining semaglutide and dapagliflozin in elderly patients with type 2 diabetes mellitus (T2DM) whose conditions were not well controlled by metformin, as well as the effects on catalase (CAT), superoxide dismutase (SOD), and 2-hour postprandial blood glucose (2hPBG) levels. Methods: A total of 65 cases were selected from January 2024 to January 2025 and randomly divided into two groups using a random number table: the control group (n = 32, treated with dapagliflozin) and the observation group (n = 33, treated with semaglutide in addition to dapagliflozin). The overall therapeutic efficacy and incidence of adverse reactions were assessed in both groups. Results: After appropriate treatment, the levels of blood glucose, 2hPBG, and HbA1c were significantly better in the observation group compared to the control group (P < 0.05). In terms of fasting insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR), and homeostasis model assessment of β-cell function (HOMA-β), the levels of FINS and HOMA-IR decreased, while HOMA-β was significantly higher in the observation group than in the control group (P < 0.05). Compared to the control group, the levels of malondialdehyde (MDA) and reactive oxygen species (ROS) were significantly lower in the observation group, while the levels of CAT and SOD were significantly higher (P < 0.05). The incidence of drug side effects was lower in the observation group, with rates of 9.09% and 6.25% respectively (χ² = 0.185, P = 0.667). Conclusion: For elderly patients with type 2 diabetes mellitus whose conditions were not well controlled by metformin, the combination of semaglutide and dapagliflozin is more effective and safer.