二甲双胍在非肥胖老年2型糖尿病患者应用的疗效及安全性  

Efficacy and safety of metformin in non obese elderly patients with type 2 diabetes

作　　者：孙毅宏[1] 王文[1] 

机构地区：[1]内蒙古医科大学第四附属医院干部保健科,内蒙古包头014030

出　　处：《疾病监测与控制》2015年第5期297-298,共2页Journal of Diseases Monitor and Control

摘　　要：目的观察二甲双胍治疗非肥胖老年2型糖尿病患者（年龄≥60岁）的疗效及安全性。方法选择2007年1月~2012年12月笔者所在医院住院治疗的98例血糖控制不佳的2型糖尿病患者,分为治疗组和对照组,治疗组50例在预混胰岛素治疗的基础上,口服二甲双胍每次250~500mg,3次/d,对照组48例继续使用胰岛素治疗,比较两组空腹血糖（FBG）和餐后2h血糖（PBG）、糖化血红蛋白（Hb A1C）、肝肾功能、血乳酸、体重等指数的变化,观察药物的副作用。结果两组治疗后,FBG、PBG、Hb A1C均有显著降低（P〈0.01﹚,但两组间比较无统计学差异。治疗组每日胰岛素用量平均减少4.2u,低血糖反应也明显减少,体重无大幅下降。对照组每日胰岛素平均用量增加5.4u,体重明显增加。两组治疗前后肝肾功能无统计学差异。98例患者无乳酸酸中毒发生。结论非肥胖老年2型糖尿病患者单用胰岛素治疗血糖控制不佳,加用二甲双胍治疗,降糖效果明确,可减少胰岛素用量,降低低血糖发生率,且使用安全。Objective To observe the metformin treated non obese elderly patients with type 2 diabetes（age ≥ 60years） in the curative effect and safety.Methods 2007 January-2012 December in our hospital treatment of 98 patients with poor glycemic control in type 2 diabetic patients, divided into treatment group and control group, 50 cases in the treatment group in the pre mixed insulin therapy on the basis of oral metformin, 250~500mg each time, 3 times a day,48 cases in the control group continued to use the insulin treatment, comparison of two groups of fasting blood glucose（FBG） and 2 hour postprandial blood glucose（PBG）, glycosylated hemoglobin（Hb A1C）, the changes of liver and kidney function, blood lactic acid, body mass index, observation on the side effects of drugs. Results the two groups after treatment, FBG, PBG, Hb A1 C decreased significantly（P〈0.01）, but no statistical difference between the two groups.Daily insulin dosage treatment group lost an average of 4.2u, hypoglycemia reaction was also decreased, no weight dropped. The control group daily insulin dosage increased average 5.4u, increase weight star. No significant differences in liver and kidney function before and after treatment in two groups. 98 patients have no lactic acidosis occurs. Conclusion non obese elderly type 2 diabetic patients with poor glucose control with insulin therapy, plus metformin,hypoglycemic effect is clear, can reduce insulin dosage, reduce the incidence of hypoglycemia, and safe use.

关 键 词：二甲双胍 2型糖尿病 老年人 非肥胖 

分 类 号：R587.1[医药卫生—内分泌]