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维格列汀联合二甲双胍与短期胰岛素强化治疗2型糖尿病的临床疗效
叶海燕,陈平
0
(四川省医学科学院·四川省人民医院老年内分泌科;成飞医院)
摘要:
【摘要】目的 探讨维格列汀联合二甲双胍与短期胰岛素强化治疗初诊2型糖尿病CT2DM患者的有效性和安全性。方法 对32例新诊断T2DM患者, HbA1c<9%的患者予以二甲双胍联合维格列汀(n=20);HbA1c≥9%的患者予以胰岛素(n=12),均治疗12周。结果 两种治疗方案均可有效降低初诊2型糖尿病空腹血糖、餐后2小时血糖及糖化血红蛋白(P<0.05)。与治疗前比较,维格列汀组显著增加患者HOMA-β,胰岛素强化组显著增加患者HOMA-β、空腹及餐后2小时C肽水平(P<0.05),维格列汀组治疗后能明显增加血清脂联素水平(P<0.05),维格列汀组对BMI无明显影响(P>0.05),维格列汀联合二甲双胍组的不良反应较小,未出现低血糖。结论 对于HbA1c<9%的患者来说,维格列汀联合二甲双胍是一种安全有效的降糖方法;而对于HbA1c≥9%的初诊2型糖尿病患者,胰岛素强化治疗可能是更好的降糖方案。
关键词:  维格列汀  二甲双胍  胰岛素强化治疗  2型糖尿病  胰岛β细胞功能  脂联素
DOI:
基金项目:四川省卫计委科研课题(30305030210)
Efficacy and safety of vildagliptin with metformin and short term intensive insulin therapy on newly detected type 2 diabetic
YE Haiyan,CHEN Ping
(Department of Endocrinology of Elderly, Sichuan Academy of Medical Science & Sichuan Provincial People’s Hospital;Chengfei Hospital)
Abstract:
【Abstract】Objective To study the efficacy and safety of vildagliptin with metformin and shortterm intensive insulin therapy on newly detected type 2 diabetic. Method 32 patients of newly diagnosed T2DM were selected in the present study. The patientswihd HbA1c less than 9% were treated with vildagliptin and metformin(vildagliptin group, n=20). The patients with HbA1c more than or equal to 9% were treated with shortterm intensive insulin therapy (intensive insulin group, n=12).All patients were treated for 12 weeks. Results The vildagliptin with metformin and intensive insulin therapy could effectively reduce fasting blood glucose, 2hour postprandial blood glucose and HbA1c (P<0.05). Compared with before treatment, the levels of HOMAβ and adiponectin of vildagliptin group significantly increased(P<0.05). The levels of HOMAβ, fasting and 2hour postprandial Cpeptide of intensive insulin group significantly increased(P<0.05). Vildagliptin group had no significant effect on BMI(P>0.05). The vildagliptin group’s adverse effects were less than the intensive insulin therapy group’s. Conclusion Vildagliptin with metformin is an effective and safe hypoglycemic program.
Key words:  Vildagliptin  Metformin  Intensive insulin therapy  Type 2 diabetes mellitus  Pancreatic β cell function  Adiponectin

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