二甲双胍单药治疗2型糖尿病患者血糖控制未达标的相关因素分析OA

Objective To analyze factors associated with failure to achieve glycemic targets in patients with type 2 diabetes mellitus(T2DM)receiving metformin monotherapy.Methods A total of 100 patients with T2DM who received metformin monotherapy at Nanyang Second People's Hospital from January 2023 to January 2024 were enrolled.According to glycemic control after 12 weeks of treatment,patients were divided into a target-achieved group(n=60)and a target-not-achieved group(n=40).General characteristics and laboratory indicators were compared between the two groups,and binary logistic regression analysis was performed to identify factors associated with failure to achieve glycemic targets.Results There were no statistically significant differences between the two groups in age,sex,body mass index,disease duration,dietary control score,weekly exercise duration,smoking history,drinking history,mean daily dose of metformin,or medication adherence(P＞0.05).Before treatment,fasting blood glucose(FBG),2-h postprandial glucose(2 h PG),and glycated hemoglobin(HbA1c)did not differ significantly between the two groups(P＞0.05).After 12 weeks of treatment,all three indicators were lower in the target-achieved group than in the target-not-achieved group(P＜0.001).The proportions of patients with baseline homeostasis model assessment of insulin resistance(HOMA-IR)≥2.69 and fasting insulin(FIN)＜10.00 mU/L were higher in the target-not-achieved group than in the target-achieved group(both P＜0.001).The target-not-achieved group also had higher tumor necrosis factor-α(TNF-α)and high-sensitivity C-reactive protein(hs-CRP)levels and lower superoxide dismutase(SOD)and 6-Keto-prostaglandin F1α(6-Keto-PGF1α)levels(P＜0.05).Multivariable logistic regression analysis showed that baseline HOMA-IR≥2.69 and higher TNF-α and hs-CRP levels were independently associated with failure to achieve glycemic targets after 12 weeks of treatment,whereas higher SOD and 6-Keto-PGF1α levels were independently associated with a lower risk of failure to achieve glycemic targets(P＜0.05).Conclusion In this study population,higher baseline HOMA-IR,TNF-α,and hs-CRP levels were associated with an increased risk of failure to achieve glycemic targets after 12 weeks of metformin monotherapy,whereas higher SOD and 6-Keto-PGF1α levels were associated with a lower risk.These findings suggest that markers related to insulin resistance,inflammation,and oxidative stress may be associated with glycemic control outcomes after metformin monotherapy;however,their predictive value,causal relationships,and clinical implications require further investigation.