CAJ | 학술논문

目的:探讨单用二甲双胍血糖未达标的初诊2型糖尿病加用沙格列汀或吡格列酮治疗的疗效及安全性. 方法:82例单用二甲双胍治疗12周血糖未达标的初诊2型糖尿病患者随机分为两组,分别联合沙格列汀或吡格列酮治疗12周,观察两组患者治疗前后血糖控制情况、胰岛素抵抗指数( HOMA-IR)、体质指数( BMI)变化及两组不良反应的差别. 结果: 联合治疗12周后,两组空腹血糖(FPG)、餐后2 h血糖(2hPG)和糖化血红蛋白(HbA1c)均较治疗前明显降低(P<0. 05),沙格列汀组2hPG及HbAlc下降幅度优于吡格列酮组(P<0. 05),但FPG下降幅度小于吡格列酮组(P<0. 05). 吡格列酮组空腹胰岛素水平下降及HOMA-IR的改善优于沙格列汀组(P<0. 05),沙格列汀组治疗后BMI无改变(P>0. 05),吡格列酮组治疗后BMI增加(P<0. 05);两组患者药品不良反应比较,差异无统计学意义(P>0. 05). 结论:单用二甲双胍血糖控制不佳的初诊2型糖尿病患者加用沙格列汀或吡格列酮均能有效控制血糖,改善胰岛素抵抗,沙格列汀更适合于合并器质性心脏病或老年患者.
목적:탐토단용이갑쌍고혈당미체표적초진2형당뇨병가용사격렬정혹필격렬동치료적료효급안전성. 방법:82례단용이갑쌍고치료12주혈당미체표적초진2형당뇨병환자수궤분위량조,분별연합사격렬정혹필격렬동치료12주,관찰량조환자치료전후혈당공제정황、이도소저항지수( HOMA-IR)、체질지수( BMI)변화급량조불량반응적차별. 결과: 연합치료12주후,량조공복혈당(FPG)、찬후2 h혈당(2hPG)화당화혈홍단백(HbA1c)균교치료전명현강저(P<0. 05),사격렬정조2hPG급HbAlc하강폭도우우필격렬동조(P<0. 05),단FPG하강폭도소우필격렬동조(P<0. 05). 필격렬동조공복이도소수평하강급HOMA-IR적개선우우사격렬정조(P<0. 05),사격렬정조치료후BMI무개변(P>0. 05),필격렬동조치료후BMI증가(P<0. 05);량조환자약품불량반응비교,차이무통계학의의(P>0. 05). 결론:단용이갑쌍고혈당공제불가적초진2형당뇨병환자가용사격렬정혹필격렬동균능유효공제혈당,개선이도소저항,사격렬정경괄합우합병기질성심장병혹노년환자.
Objective:To study the efficacy and safety of saxagliptin or pioglitazone combined with metformin in the newly diag-nosed patients with type 2 diabetes mellitus(T2DM) with inadequate glycemic control by metformin alone. Methods:Totally 82 newly diagnosed T2DM patients with inadequately control by metfomin monotherapy for 12 weeks were randomly divided into two groups, sax-agliptin group ( saxagliptin combined with metforminc) and pioglitazone group ( pioglitazone combined with metformin) . The blood glu-cose control, homeostatic model assessment of insulin resistance index ( HOMA-IR) , body weight change and adverse reactions were assessed before and after the treatment for 12 weeks. Results:After the 12-week treatment,the level of fasting plasma glucose ( FPG) , two-hour postprandial plasma glucose (2hPG) and glyeosylated hemoglobin(HbA1c) in both groups were significantly decreased. Compared with the pioglitazone group,the level of 2hPG and HbAlc was lower while the level of FPG was higher in the saxagliptin group (P<0. 05). Compared with the saxagliptin group,the level of fasting plasma insulin(FINS) was significantly decreased and HOMA-IR was significantly improved in the pioglitazone group. The body mass index ( BMI) of the patients was increased in the pioglitazone group(P<0. 05) and showed no change in the saxagliptin group(P>0. 05). There was no statistical difference in the adverse reac-tions between the two groups(P>0. 05). Conclusion:The combination of saxagliptin or pioglitazone with metformin in the treatment of newly diagnosed patients with type 2 diabetes can improve glycemic control with low incidence of hypoglycemia and adverse reactions. Saxagliptin is more suitable for the patients with heart diseases or old patients.