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  

Effects of Salgletine and Glimepiride on Insulin Resistance, Waist Circumference and Waist-to-hip Ratio in T2MD Patients with Metformin Secondary Failure

作　　者：宋艳艳 SONG Yan-yan(Xinan first people's hospital second department of general surgery, Luoyang Henan 471003,China)

机构地区：[1]新安县第一人民医院普外科,河南洛阳471003

出　　处：《药品评价》2019年第8期56-58,共3页Drug Evaluation

基　　金：河南省自然科学基金资助项目;编号:162300410218

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 (T2MD)patients with metformin secondary failure. Methods: 102 T2MD 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), 2h postprandial glucose (2hPBG), 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, 2h 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 significant difference between the two groups (P>0.05), but there was no significant difference between the two groups before and after treatment (P>0.05). Conclusion: The hypoglycemic effect of combined use of salgletine in T2MD 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.

关 键 词：沙格列汀 格列美脲 T2MD 胰岛素抵抗 

分 类 号：R587.1[医药卫生—内分泌]