达格列净因其非胰岛素依赖性降糖作用及多种获益，部分国家已批准用于1型糖尿病患者，但临床医师对其引起的非高血糖性糖尿病酮症酸中毒目前认识相对不足。该文报道1例50岁成人隐匿性自身免疫性糖尿病患者在应用达格列净6 d后出现的酮症酸中毒，并进行国内外文献复习，期望提高对该病的认识。

目的 评估糖尿病性胃轻瘫患者应用多潘立酮联合依帕司他治疗的效果.方法 选择医院在2019年9月-2021年6月接诊的50例糖尿病性胃轻瘫患者,根据随机数表法进行分组,对照组给予口服多潘立酮治疗,观察组给予多潘立酮联合依帕司他治疗.比较两组糖尿病性胃轻瘫患者的治疗效果.结果 观察组治疗总有效率(96.00％)高于对照组,差异有统计学意义(x2=6.640,P＜0.05).治疗后,观察组消化道症状积分、食管底部横截面积、胃泌素均低于对照组,差异有统计学意义(P＜0.05).观察组平均胃排空率、胃电主功率比、胃电主频率比均高于对照组,差异有统计学意义(P＜0.05).治疗后,观察组空腹血糖、餐后2 h血糖、糖化血红蛋白、不良反应发生率均低于对照组,差异有统计学意义(P＜0.05).结论 糖尿病性胃轻瘫患者应用多潘立酮联合依帕司他治疗的疗效显著,值得在临床中予以推广使用.

Objective:To investigate the effect of dapagliflozin on aldosterone to renin ratio (ARR) in patients with type 2 diabetes mellitus (T2DM) complicated with hypertension.Methods:Patients with T2DM and hypertension who were admitted to the Department of Endocrinology, Beijing Huairou Hospital from September 2019 to December 2020 were enrolled. Body weight, fasting blood glucose (FPG), glycosylated hemoglobin (HbA 1c), uric acid, plasma renin concentration, aldosterone level and other indicators were measured and recorded before treatment, and ARR was calculated. Patients were treated with dapagliflozin for 12 weeks, and hematologic indicators were collected again while ARR was also calculated. Paired t test or Mann-Whitney U test were used to compare the ARR and related indexes before and after treatment of dapagliflozin. Results:A total of 20 patients were enrolled. ARR before and after treatment were 0.86 (0.73, 1.20) and 0.95 (0.72, 1.32), respectively. However, there was no significant difference between them ( Z=1.12, P=0.263). After 12 weeks of dapagliflozin, FPG ( Z=-3.62, P<0.001), HbA 1c ( Z=-3.76, P<0.001), body weight ( Z=-3.19, P=0.001) and uric acid ( Z=-2.71, P=0.014) decreased significantly compared with baseline. Conclusions:Dapagliflozin has no effect on ARR in patients with T2DM complicated with hypertension, but it has good effects on reducing FPG, uric acid and weight loss.