西格列汀联合二甲双胍治疗老年2型糖尿病疗效分析

Efficacy of sitagliptin combined with metformin in treatment of type 2 diabetes mellitus in the elderly

摘要:

目的 探讨单服二甲双胍(metformin)治疗未达标的老年2型糖尿病患者(T2DM)加用西格列汀(sitagliptin)的有效性及安全性。方法 入选2015年5月至2016年9月中关村医院内分泌科单服二甲双胍控制不佳的老年T2DM患者52例,其中男性30例,女性22例,年龄65～78(68.0±8.0)岁。随机分成西格列汀组和阿卡波糖(acarbose)组,每组26例(男性15例,女性11例)。西格列汀组患者口服西格列汀100 mg/次,1次/d,阿卡波糖组患者口服阿卡波糖50 mg/次,3次/d,两组患者同时口服二甲双胍500 mg/次,3次/d,连续治疗12周。观察两组患者服药12周后空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)等指标变化,并记录低血糖、胃肠道不良反应的发生情况。结果 两组患者治疗前FPG、2hPG和HbA1c差异均无统计学意义(P＞0.05)；治疗12周后,两组患者FPG、2hPG和HbA1c较治疗前均明显降低,并且西格列汀组较阿卡波糖组2hPG和HbA1c下降更显著,差异有统计学意义(P＜0.05)。治疗期间两组患者无低血糖发生,阿卡波糖组4例发生腹胀,排气增加,两组患者不良反应发生差异无统计学意义(P＞0.05)。结论 西格列汀与二甲双胍联用治疗T2DM患者疗效显著且安全。

Abstract:

Objective To compare the efficacy and safety of combining sitagliptinin to therapy type 2 diabetes mellitus (T2DM) of elderly patients with inadequate glycemic controlled by metformin monotherapy.Methods A total of 52 T2DM elderly patients [30 males and 22 females, at an age of (68.0±8.0) years, ranging from 65 to 78] with inadequate glycemic controled by metformin monotherapy admitted in our department from May 2015 to September 2016 were recruited in this study. They were randomly divided into sitagliptin group and acarbose group, with 26 ones in each. Besides oral administration of 500 mg metformin (3 times per day), the former group was treated with 100 mg sitagliptin (once per day), and the latter with 50 mg acarbose (3 times per day), for 12 consecutive weeks.Then fasting plasma glucose(FBG), 2-hour postprandial glucose(2hPG), hemoglobin A1c(HbA1c) and body mass index (BMI)were measured in the 2 groups. The incidences of hypoglycemia and gastrointestinal adverse reactions were observed. ResultsNo difference was seen in the FBG, 2hPG and HbA1c in the 2 groups before treatment (P>0.05). After the treatment, the above 3 indicators were significantly reduced (P<0.05). The declines of 2hPG and HbA1c were more obvious in the sitagliptin group than acarbose group (P<0.05). No hypoglycemia was observed during treatment. In acarbose group, 4 cases complained of abdominal distention and increased flatus passage. No statistical difference was observed in gastrointestinal adverse reactions between two groups (P>0.05). Conclusion Combined of sitagliptin with metformin shows significant efficacy and safety in treatment of T2DM elderly patients.