论文部分内容阅读
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(2h PG)和糖化血红蛋白(Hb A1c)均较治疗前明显降低(P<0.05),沙格列汀组2h PG及Hb Alc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。
Objective: To investigate the efficacy and safety of newly diagnosed type 2 diabetes with metformin blood glucose alone and saxagliptin or pioglitazone. Methods: A total of 82 patients with newly diagnosed type 2 diabetes mellitus who did not meet the standard of 12-week blood glucose treatment were randomly divided into two groups and were treated with either saxagliptin or pioglitazone for 12 weeks respectively. The blood glucose control, insulin resistance index (HOMA-IR), body mass index (BMI) changes and the difference between the two groups of adverse reactions. Results: The fasting blood glucose (FPG), 2h PG and Hb A1c in both groups were significantly lower than those before treatment (P <0.05) after 12 weeks of combination therapy, while those in the sitagliptin group for 2h PG and Hb Alc decline better than pioglitazone group (P <0.05), but FPG decreased less than pioglitazone group (P <0.05). The decrease of fasting insulin and the improvement of HOMA-IR in pioglitazone group were better than those in saxagliptin group (P <0.05). The BMI in saxagliptin group did not change (P> 0.05), and the BMI in pioglitazone group increased (P < 0.05). There was no significant difference in adverse drug reactions between the two groups (P> 0.05). Conclusions: Patients with newly diagnosed type 2 diabetes mellitus with low glycemic control alone and metformin plus either saxagliptin or pioglitazone can effectively control blood glucose and improve insulin resistance. Saxagliptin is more suitable for those with organic heart disease or elderly patients.