瑞格列奈或西格列汀联合甘精胰岛素治疗初发2型糖尿病疗效观察  

CLINICAL COMPARATIVE STUDY OF REPAGLINIDE AND SITAGLIPTIN WITH INSULIN GLARGINE IN THE TREATMENT OF NEWLY DIAGNOSED TYPE 2 DIABETES

作　　者：梁勇前[1] 刘湘茹[1] 胡德龙[1] 罗蓓[1] 

机构地区：[1]佛山市顺德区第一人民医院,广东佛山528300

出　　处：《现代医院》2015年第6期29-31,34,共4页Modern Hospitals

摘　　要：目的研究瑞格列奈或西格列汀联合甘精胰岛素对初发2型糖尿病患者血糖控制、安全性及对胰岛β细胞功能改善的情况。方法将60例2型糖尿病患者分为瑞格列奈联合甘精胰岛素治疗组(A组)和西格列汀联合甘精胰岛素治疗组(B组),每组30例,A组每日睡前注射一次甘精胰岛素,联合三餐前口服瑞格列奈;B组每日睡前注射一次甘精胰岛素,联合早餐前口服西格列汀,随访24周。检测两组治疗前后空腹血糖、餐后2小时血糖、糖化血红蛋白、胰岛素、体重指数等指标,比较两组患者治疗前后血糖控制情况、胰岛β细胞功能恢复情况及安全性。结果 A组和B组治疗24周后空腹血糖、餐后2小时血糖、糖化血红蛋白明显下降,早期胰岛素分泌指标ΔI30/ΔG30、基础胰岛素分泌指标HOMAβ均较治疗前改善,差异有统计学意义(p<0.05);但A、B两组比较无统计学意义(p>0.05);体重指数的变化,A组治疗后的体重指数较治疗前有所上升,有统计学差异,B组治疗前后体重指数变化不大;A组有7例低血糖症的发生,其中有1例为严重的低血糖症,而B组无低血糖症发生,两组之间低血糖症发生率有统计学意义(p<0.05)。结论初诊2型糖尿病采用瑞格列奈或西格列汀联合甘精胰岛素的方案都具有明显的降低空腹血糖、餐后血糖和Hb Alc并改善胰岛功能的作用,且两者的治疗效果相当,A组治疗后体重较治疗前有所上升,B组治疗前后对体重的变化不大,两组低血糖发生率无差别。Objective To investigate the therapeutic effect of repaglinide and sitagliptin with insulin glargine once daily, including blood glucose controling, safety and improvement of islet β- cell in newly diagnosed type 2 dia- betics. Methods Sixty patients with type 2 diabetes patients were divided into two groups. Repaglinide with insulin glargine group （Group A） was administered with repaglinide before meals. Sitagliptin with insulin glargine group （Group B） was administered with sitagliptin before breakfast. All patients were treated for 24 weeks. The values of FBS, PBS, HbAlc, insulin, and BMI were checked, and glucose control, islet function and safety were periodically measured and compared. Results In both groups, the level of FBS, PBS and HbAlc decreased significantly and the level of △I30/△G30 and HOMAβ were improved （p 〈 0.05 ）, but there was no significant difference between two groups （p 〉 0.05）. The BMI in group A after the treatment was significantly higher than that of before, but there was no significant difference in group B. Hypoglycemia did occur in 7 case（ including 1 serious case） in group A and did not occur in group B. There was significant difference between the two groups （p 〈 0.05）. Conclusion Repaglinide or sitagliptin with insulin glargine for newly diagnosed type 2 diabetes patients could equally reduce the level of FBS, PBS and HbAlc, and improve the function of islet significantly. The weight in group A after the treatment was signifi- cantly higher than that of before, but there was no significant difference in group B. There was significant difference for the incidence of hypoglycemia in two groups.

关 键 词：瑞格列奈 西格列汀 甘精胰岛素 2型糖尿病 

分 类 号：R977.15[医药卫生—药品]