沙格列汀、格列美脲对二甲双胍继发失效T2MD患者胰岛素抵抗、腰围、腰臀比的影响
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摘要
目的:探究沙格列汀、格列美脲对二甲双胍继发失效2型糖尿病(Type 2 diabetes mellitus, T2MD)患者胰岛素抵抗、腰围、腰臀比的影响。方法:用计算机随机数字法将102例二甲双胍继发失效T2MD患者分为观察组和对照组,各51例。两组患者均继续服用二甲双胍,对照组加用格列美脲,观察组加用沙格列汀。比较两组患者治疗前后的糖代谢情况[空腹血糖(Fasting blood glucose, FBG)、2h餐后血糖(2h postprandial blood sugar,2h PBG)、空腹胰岛素(Fasting insulin,FINS)、胰岛素抵抗指数(Insulin resistance index, HOMA-IR)]和身体情况[体质指数(Body mass index,BMI)、腰围、腰臀比]。结果:治疗24周后,两组患者FBG、2hPBG、HOMA-IR水平均较治疗前降低,FINS则较治疗前升高(P<0.05),观察组患者FBG、FINS水平高于对照组,2hPBG、HOMA-IR水平则低于对照组(P<0.05);治疗24周后,两组患者BMI水平均较治疗前降低,且观察组低于对照组(P<0.05),腰围也较治疗前降低,但组间比较差异无统计学意义(P>0.05),两组患者治疗前后腰臀比比较,差异均无统计学意义(P>0.05)。结论:对二甲双胍继发失效T2MD患者,联合应用沙格列汀的降糖效果好于联合应该格列美脲,且能较好控制体重和皮下脂肪水平。
Objective: To investigate the effects ofsalgletine and glimepiride on insulin resistance, waist circumference and waist to hip ratio in type 2 diabetes mellitus(T2 MD)patients with metformin secondary failure. Methods: 102 T2 MD patients with metformin secondary failure were randomly divided into observation group(n = 51)and control group(n = 51). The two groups continued to take metformin, the control group plus glimepiride, the observation group plus salgletine. The glucose metabolism before and after treatment[fasting glucose(FBG), 2 h postprandial glucose(2 hPBG), fasting insulin(FINS), insulin resistance index(HOMA)] and body condition[body mass index(BMI), waist circumference, waist to hip ratio]were compared between the two groups.-IR]. Results: After 24 weeks of treatment, the levels of FBG, 2 h PBG, HOMA-IR and FINS in both groups were lower than those before treatment(P<0.05).The level of FBG, FINS in the observation group was higher than that in the control group. The level of HOMA-IR was lower than that of control group(P<0.05). After 24 weeks of treatment, the level of BMI in both groups was lower than that before treatment, and the observation group was lower than the control group(P<0.05), and the waist circumference was also lower than that before treatment, but there was a difference between the two groups. There was no signi?cant difference between the two groups(P>0.05), but there was no signi?cant difference between the two groups before and after treatment(P>0.05).Conclusion: The hypoglycemic effect of combined use of salgletine in T2 MD patients with secondary failure of metformin is better than that in combination with glimepiride, and the body weight and subcutaneous fat level can be well controlled.
Objective: To investigate the effects ofsalgletine and glimepiride on insulin resistance, waist circumference and waist to hip ratio in type 2 diabetes mellitus(T2 MD)patients with metformin secondary failure. Methods: 102 T2 MD patients with metformin secondary failure were randomly divided into observation group(n = 51)and control group(n = 51). The two groups continued to take metformin, the control group plus glimepiride, the observation group plus salgletine. The glucose metabolism before and after treatment[fasting glucose(FBG), 2 h postprandial glucose(2 hPBG), fasting insulin(FINS), insulin resistance index(HOMA)] and body condition[body mass index(BMI), waist circumference, waist to hip ratio]were compared between the two groups.-IR]. Results: After 24 weeks of treatment, the levels of FBG, 2 h PBG, HOMA-IR and FINS in both groups were lower than those before treatment(P<0.05).The level of FBG, FINS in the observation group was higher than that in the control group. The level of HOMA-IR was lower than that of control group(P<0.05). After 24 weeks of treatment, the level of BMI in both groups was lower than that before treatment, and the observation group was lower than the control group(P<0.05), and the waist circumference was also lower than that before treatment, but there was a difference between the two groups. There was no signi?cant difference between the two groups(P>0.05), but there was no signi?cant difference between the two groups before and after treatment(P>0.05).Conclusion: The hypoglycemic effect of combined use of salgletine in T2 MD patients with secondary failure of metformin is better than that in combination with glimepiride, and the body weight and subcutaneous fat level can be well controlled.
引文
[1]张丹丹,孙娜,房辉,等.甘精胰岛素注射液联合格列美脲片治疗2型糖尿病的临床研究[J].中国临床药理学杂志, 2018, 34(3):251-253.
[2]林毅辉,何芳,高洁,等.沙格列汀联合二甲双胍治疗维吾尔族老年2型糖尿病的疗效[J].中国老年学杂志, 2017, 37(19):4801-4802.
[3]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中华内分泌代谢杂志, 2014, 30(10):893-942.
[4]李斐,曲震理.西格列汀联合二甲双胍治疗2型糖尿病伴非酒精性脂肪肝的临床研究[J].中国临床药理学杂志, 2018, 34(5):518-520, 527.
[5]蒲丹岚,尹经霞,谢洁,等.复方盐酸吡格列酮格列美脲片与格列美脲片治疗2型糖尿病的疗效与安全性对照研究[J].重庆医学, 2018, 47(7):915-918.
[6]张娜,肖丽华.沙格列汀联合阿卡波糖治疗初诊老年2型糖尿病的疗效[J].中国生化药物杂志, 2017, 37(7):224-225, 228.
[7]张萍,潘天荣,杜益君,等.不同病程超重T2DM患者加用沙格列汀治疗后临床疗效及安全性观察[J].安徽医科大学学报, 2018, 53(9):1457-1460.
[8]董慧,田坚,张盈妍,等.沙格列汀联合二甲双胍治疗2型糖尿病伴非酒精性脂肪肝的临床效果[J].广西医学, 2017, 39(3):316-318.
[2]林毅辉,何芳,高洁,等.沙格列汀联合二甲双胍治疗维吾尔族老年2型糖尿病的疗效[J].中国老年学杂志, 2017, 37(19):4801-4802.
[3]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中华内分泌代谢杂志, 2014, 30(10):893-942.
[4]李斐,曲震理.西格列汀联合二甲双胍治疗2型糖尿病伴非酒精性脂肪肝的临床研究[J].中国临床药理学杂志, 2018, 34(5):518-520, 527.
[5]蒲丹岚,尹经霞,谢洁,等.复方盐酸吡格列酮格列美脲片与格列美脲片治疗2型糖尿病的疗效与安全性对照研究[J].重庆医学, 2018, 47(7):915-918.
[6]张娜,肖丽华.沙格列汀联合阿卡波糖治疗初诊老年2型糖尿病的疗效[J].中国生化药物杂志, 2017, 37(7):224-225, 228.
[7]张萍,潘天荣,杜益君,等.不同病程超重T2DM患者加用沙格列汀治疗后临床疗效及安全性观察[J].安徽医科大学学报, 2018, 53(9):1457-1460.
[8]董慧,田坚,张盈妍,等.沙格列汀联合二甲双胍治疗2型糖尿病伴非酒精性脂肪肝的临床效果[J].广西医学, 2017, 39(3):316-318.