二甲双胍联合维格列汀治疗2型糖尿病临床疗效分析

目的 讨论二甲双胍联合维格列汀治疗2型糖尿病的临床疗效。方法 73例2型糖尿病患者,随机分为二甲双胍组(34例)和二甲双胍联合维格列汀组(39例),测定两组患者治疗前后空腹血糖(FBG)、口服葡萄糖耐量试验餐后2 h血糖(2 h FPG)、糖化血红蛋白(Hb A1c)、血脂、肾功、体质量指数(BMI)等生化指标。结果 组内比较二甲双胍组FBG、OGTT2 h、Hb A1c治疗后明显低于治疗前,差异有统计学意义(P<0.05),二甲双胍联合维格列汀组FBG、OGTT2 h、Hb A1c、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)治疗后明显低于治疗前,差异有统计学意义(P<0.05)。组间比较,治疗前二甲双胍组和二甲双胍联合维格列汀组各指标差异无统计学意义(P>0.05),治疗后二甲双胍联合维格列汀组BMI、LDL-C、TC明显低于二甲双胍组,差异有统计学意义(P<0.05)。结论 二甲双胍联合维格列汀具有良好降糖降血脂疗效。     

2型糖尿病患者采取维格列汀联合二甲双胍治疗的效果及安全性分析

目的:探究分析2型糖尿病患者采取维格列汀联合二甲双胍治疗的效果及安全性.方法:本次试验时间范围选为2017年1月至2019年12月,在该时间范围内选取106例老年糖尿病患者作为观察对象,按照随机分组法将其平均分为对照组与观察组两组并分别给单纯二甲双胍治疗以及维格列汀联合二甲双胍治疗,比较两种治疗方法的治疗效果.结果:观...     

维格列汀伍用丹参舒心胶囊对早期2型糖尿病患者肺功能的影响

目的 观察维格列汀联合丹参舒心胶囊对早期二甲双胍单药治疗不佳的2型糖尿病(T2DM)患者肺功能的影响,并对其有效性及安全性进行评价.方法 选择早期(无微血管病变)经二甲双胍单药治疗且效果不佳的T2DM患者74例,随机分为观察组(n=38)和对照组(n=36),选择同期体检健康40例为健康组.对照组予二甲双胍(1000 mg、2次/d)、银杏叶提取物片(40 mg、3次/d)、甲钴胺(0.5 mg、2次/d)等口服治疗,观察组予二甲双胍500 mg、3次/d)、维格列汀(50 mg、2次/d)、银杏叶提取物片(40 mg、3次/d)+丹参舒心胶囊(0.4 g、2次/d)、甲钴胺(0.5 mg、2次/d)口服治疗.治疗前记录3组血糖及肺功能等基本资料.T2DM患者连续治疗24周后观察2组治疗后空腹血糖(FBG)、餐后2 h血糖(2 hPG)、体重指数(BMI)与肺功能[肺活量(VC%)、用力肺活量(FVC%)、1 s用力呼气流量(FEV1%)、最大呼气峰流速(PEF%)、最大自主通气量(MVV%)、肺总量(TCL%)、一秒率(FEV1/FVC%)、肺一氧化碳弥散量(DLCO%)、肺单位体积一氧化碳弥散量(DLCO/VA%)]的变化情况,记录治疗过程中的不良反应.结果 治疗前T2DM患者的FBG、2 hPG、BMI均高于健康组(P<0.05),肺功能各项指标均低于健康组(P<0.05).治疗后T2DM两组FBG、2 hPG均低于治疗前(P<0.05),但2组FBG、2 hPG及BMI治疗前后比较差异均无统计学意义(P>0.05).治疗后2组肺功能均优于治疗前(P<0.05),治疗后观察组肺功能优于对照组(P<0.05).结论 T2DM患者早期即出现肺功能下降,维格列汀联合丹参舒心胶囊在控制血糖的同时能较好改善患者的肺功能,且安全可靠,不增加体重.     

维格列汀联合二甲双胍治疗2型糖尿病的效果及安全性观察

目的 研究2型糖尿病患者在采取维格列汀联合二甲双胍治疗的效果及安全性.方法 55例2型糖尿病患者,按治疗方式不同分为观察组(28例)和对照组(27例).观察组采取维格列汀联合二甲双胍治疗,对照组采取单一的二甲双胍治疗.比较两组血糖控制水平、不良反应发生情况.结果 治疗后,观察组空腹血糖、餐后2 h血糖分别为(5.26±...     

二甲双胍联合维格列汀治疗肥胖型2型糖尿病的临床观察

目的探究二甲双胍联合维格列汀治疗肥胖型2型糖尿病的临床疗效。方法选取2010年3月—2013年2月来重庆市忠县人民医院就诊的肥胖型2型糖尿病患者106例,依据分层随机分组法将患者分为治疗组(53例)和对照组(53例)。对照组给予常规疗法,随餐同服二甲双胍0.5 g/次,2次/d,后依据病情以0.5 g/2周逐渐增量,最大剂量不超过2.5 g/d,同时早餐前口服吡格列酮,起始剂量15 mg/d,最大剂量不超过45 mg/d;治疗组口服二甲双胍,用法用量同对照组,同时随餐口服维格列汀50 mg/次,2次/d。两组患者均治疗6个月。比较两组患者治疗前后体质量指数(BMI)、糖化血红蛋白(HbA1c)、糖化白蛋白(GSP)、空腹血糖(FBG)、餐后2小时血糖(2hPBG)、胰高血糖素样肽-1(GLP-1)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、治疗总有效率,同时观察两组患者可能出现的不良反应。结果治疗后两组患者的BMI、HbA1c、GSP、FBG、2hPBG、TG、TC及LDL-C均较治疗前有所下降,差异均有统计学意义(P<0.05);治疗后,治疗组患者的BMI、HbA1c、GSP、FBG、2hPBG、TG、TC及LDL-C均较对照组下降更加明显,差异有统计学意义(P<0.05)。治疗后治疗组患者的GLP-1和HDL-C均明显高于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,治疗组和对照组的总有效率分别为98.11%、86.79%,两组比较差异有统计学意义(P<0.05)。结论二甲双胍联合维格列汀治疗肥胖型2型糖尿病可有效控制患者的血糖和体质量,且不增加低血糖风险,同时也可达到降低血脂的作用,值得临床推广应用。     

维格列汀联合二甲双胍2型糖尿病的临床疗效观察

目的:探究维格列汀联合二甲双胍治疗2型糖尿病的临床疗效观察。方法:选取我院2020年5月—2022年6月2型糖尿病的患者80例为研究对象,按照治疗方式的不同,分为对照组和观察组,每组各40例,两组均行常规治疗方式,对照组在此基础上采用二甲双胍治疗,观察组在对照组的基础上采取联合维格列汀治疗,对比两组患者临床效果、FGB、2hPG、HbAlc、胰岛素β细胞功能指标。结果:在治疗后,观察组的临床总有效率(97.50%)高于对照组的临床总有效率(82.50%),差异具有统计学意义(x²=5.000,P=0.025);治疗前,比较两组患者的血糖指标FPG、2hPG、HbAlc(P>0.05);治疗后,观察组的血糖指标FPG、2hPG、HbAlc均低于对照组(P<0.05);治疗前,比较两组患者的FINS、FC-P、HOMA-IR以及HOMA-β胰岛素β细胞功能指标(P>0.05);治疗后,观察组的FINS、FC-P以及HOMA-β均高于对照组、HOMA-IR低于对照组(P<0.05)。结论:维格列汀联合二甲双胍治疗2型糖尿病患者能够发挥两者互补、协...     

维格列汀联合二甲双胍治疗初诊2型糖尿病伴腹型肥胖患者的疗效及对血清kisspeptin的影响

目的 探讨维格列汀联合二甲双胍治疗初诊2型糖尿病伴腹型肥胖的疗效及对血清吻素（kisspeptin）水平的影响。方法 按前瞻性、随机、开放、对照、单中心临床研究方法设计。选取2020年1月—2020年12月在河北医科大学第三医院门诊诊治的初诊2型糖尿病伴腹型肥胖患者,通过简便估算样本量方法,共计纳入80例患者为研究对象,按照随机数字表法将80例患者随机分为对照组和试验组,每组40例。对照组患者服用盐酸二甲双胍片,每次1片,每天3次;试验组在对照组基础上加用维格列汀,每次1片,每天2次,两组疗程均为3个月。比较两组患者治疗前后收缩压（SBP）、舒张压（DBP）、腰围、臀围、腰臀比（WHR）、体质量、体质量指数（BMI）、空腹血糖（FPG）、空腹胰岛素（FINS）、胰岛素抵抗指数（HOMA-IR）、胰岛β细胞功能指数（HOMA-β）、糖化血红蛋白A₁C（HbA₁C）、餐后2 h血糖（2hPG）、三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）和血清kisspeptin水平,观察两组临床疗效及治疗期间不良反应的发生情况。结果 治疗前,对照组和试验组各项糖脂代谢相关指标比较,组间差异无统计学意义（P>0.05）。治疗后,两组患者SBP、DBP、腰围、臀围、WHR、体质量、BMI、FPG、2hPG、HOMA-IR、HbA₁C、TG、TC、LDL-C、kisspeptin均较治疗前有所下降（P<0.05）,且FINS、HOMA-β较治疗前有所升高（P<0.05）。治疗后,试验组在改善腰围、臀围、BMI、FPG、FINS、2hPG、TG、kisspeptin和HOMA-β等指标方面,效果优于对照组（P<0.05）。治疗后,试验组的总有效率为97.5%,对照组的总有效率为82.5%,两组比较差异有统计学意义（P<0.05）。治疗期间,对照组患者发生的不良反应为恶心呕吐2例次,头疼头晕1例次;试验组患者发生的不良反应为恶心呕吐1例次,头疼头晕1例次,两组的总不良反应发生率差异无统计学意义（P>0.05）。结论 维格列汀联合二甲双胍治疗初诊2型糖尿病伴腹型肥胖临床安全有效,患者无体质量增加的风险,两药联用可以显著降低血糖水平,改善胰岛β细胞功能,减轻胰岛素抵抗,改善脂代谢水平,降低血清kisspeptin水平,不增加药物不良反应发生率,值得推广。     

维格列汀联合二甲双胍治疗老年2型糖尿病的临床疗效研究

目的：研究维格列汀联合二甲双胍治疗2型糖尿病老年患者的临床疗效。方法选取符合2型糖尿病诊断标准的60岁以上老年患者120例,按双盲法随机分为治疗组（60例）,采用维格列汀联合二甲双胍治疗及对照组（60例）采用二甲双胍加安慰剂治疗,半年后观察对比分析两组患者的情况。结果治疗前无差异,治疗半年后,治疗组在FBG、2hPG、HbA1c及BMI方面明显低于对照组（P＜0.05）,而不良反应发生率在两组间没有明显差异。结论维格列汀联合二甲双胍对于治疗老年2型糖尿病有较好的疗效。     

西格列汀与维格列汀联合二甲双胍治疗2型糖尿病的有效性及经济性研究

目的 探讨西格列汀与维格列汀联合二甲双胍治疗2型糖尿病的有效性及经济性.方法 选取2019年1-12月延安大学附属医院收治的2型糖尿病患者104例,应用随机数字表法分为西格列汀组与维格列汀组,各52例.西格列汀组在基础干预和二甲双胍治疗基础上联合西格列汀治疗,维格列汀组在基础干预和二甲双胍治疗基础上联合维格列汀治疗,2...     

Safety and efficacy of metformin up-titration in Japanese patients with type 2 diabetes mellitus treated with vildagliptin and low-dose metformin

Background: This study investigated the safety and efficacy of metformin up-titration in Japanese patients with type 2 diabetes mellitus treated with vildagliptin (100 mg/day) and low-dose metformin (500 or 750 mg/day).

Research design and methods: Fifty patients were randomly allocated to the control group (maintaining the initial low-dose of metformin) and the dose increase group (up-titrating of metformin to 1,500–2,250 mg/day) for 24 weeks. The primary outcome was change in HbA1c from baseline to 24 weeks.

Results: Among the 25 patients allocated to the dose increase group, four patients were not able to complete the study protocol because of gastrointestinal symptoms. HbA1c in the dose increase group was significantly but modestly lower than in the control group (change in HbA1c: 0.22 ± 0.57 vs. ?0.15 ± 0.58%, group comparison, P < 0.05). The dose increase group did not gain weight during the study period, and no hypoglycemic events were reported in both groups. The rate of gastrointestinal symptoms in the dose increase group was profoundly higher than in the control group (32 vs. 0%, P < 0.01).

Conclusions: In Japanese patients with type 2 diabetes treated with vildagliptin and low-dose metformin, metformin up-titration significantly but modestly improved glycemic control without hypoglycemia and weight gain.     

维格列汀联合二甲双胍对超重2型糖尿病病人代谢指标的影响

目的 观察维格列汀与二甲双胍联合应用对超重2型糖尿病病人代谢指标的综合影响,评价其疗效。方法 选取2013年12月至2016年10月中国人民解放军第三〇五医院收治单独应用二甲双胍(500 mg,3次/天,服用3个月以上)血糖控制不佳的超重2型糖尿病病人120例,按随机数字表法分为观察组(60例)和对照组(60例)。对照组口服二甲双胍剂量增加至1 000 mg、2次/天;观察组予口服二甲双胍500 mg、3次/天,并联用维格列汀50 mg、2次/天,共24周。比较治疗前后体质量指数(BMI)、糖化血红蛋白(HbA_1c)、空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、总胆固醇(TC)、三酰甘油(TG) 和低密度脂蛋白胆固醇(LDL-C)、同型半胱氨酸(Hcy)等指标的变化。结果 治疗24周后,对照组FBG、2 h PBG、HbA_1c分别为(7.98±0.83)mmol/L、(12.25±0.90)mmol/L、(8.05±1.05)%,观察组分别为(7.09±0.80) mmol/L、(9.86±1.13)mmol/L、(7.01±0.88)%,两组FBG、2 h PBG、HbA_1c 均较治疗前降低(P＜0.05),观察组较对照组下降更明显(t值分别为:2.47、5.27、3.22,均P＜0.05);治疗24周后,对照组BMI、TC、TG、LDL-C、Hcy分别为(27.60±3.70) kg/m²、(6.39±0.89) mmol/L、(2.77±0.40) mmol/L、(3.29±0.43) mmol/L、(17.4±2.03) mmol/L,观察组分别为(26.34±3.83) kg/m²、(5.31±0.72) mmol/L、(2.31±0.33) mmol/L、(2.92±0.44) mmol/L、(15.16±1.74) mmol/L,与治疗前比较,两组BMI、血脂、Hcy水平均显著下降(P＜0.05),观察组下降更显著(t值分别为:2.14、3.50、2.26、2.21、3.27,均P＜0.05)。两组不良反应发生率差异无统计学意义(χ²=2.62,P＞0.05)。结论 维格列汀联合二甲双胍能够有效控制肥胖或超重的2型糖尿病病人的血糖及BMI,并且能够改善血脂,降低血糖,且不增加低血糖风险,是超重或肥胖2型糖尿病病人有效治疗方案之一。     

Combination therapy with metformin plus vildagliptin in type 2 diabetes mellitus

Introduction: Type 2 diabetes mellitus (T2DM) is pathophysiologically characterized by a combination of insulin resistance and beta-cell dysfunction. Consequently, a proper treatment of such a disease should target both of these defects. Dipeptidyl peptidase-4 (DPP-4) inhibitors are among the most recent additions to the therapeutic options for T2DM and are able to increase circulating levels of glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), thus stimulating glucose-dependent insulin secretion.

Areas covered: This paper provides an overview of the clinical results of combination therapy with metformin and the DPP-4 inhibitor vildagliptin in T2DM patients.

Expert opinion: Vildagliptin–metformin single-tablet combination is indicated for the treatment of T2DM patients not achieving a sufficient glycemic control at their maximally tolerated dose of metformin. Results from clinical trials provide evidence of vildagliptin efficacy administered in addition to metformin, as either first- or second-line treatment. The vildagliptin–metformin association seems to have favorable effects on beta-cell function and is characterized by good safety and tolerability profiles when compared with other antidiabetic agents. Of note, data available suggest that administration of fixed-dose combination products, together with the low incidence of adverse gastrointestinal events, may improve compliance and adherence of patients to therapy, resulting in an improved metabolic control.     

Combination therapy with metformin plus vildagliptin in type 2 diabetes mellitus

INTRODUCTION: Type 2 diabetes mellitus (T2DM) is pathophysiologically characterized by a combination of insulin resistance and beta-cell dysfunction. Consequently, a proper treatment of such a disease should target both of these defects. Dipeptidyl peptidase-4 (DPP-4) inhibitors are among the most recent additions to the therapeutic options for T2DM and are able to increase circulating levels of glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), thus stimulating glucose-dependent insulin secretion. AREAS COVERED: This paper provides an overview of the clinical results of combination therapy with metformin and the DPP-4 inhibitor vildagliptin in T2DM patients. EXPERT OPINION: Vildagliptin-metformin single-tablet combination is indicated for the treatment of T2DM patients not achieving a sufficient glycemic control at their maximally tolerated dose of metformin. Results from clinical trials provide evidence of vildagliptin efficacy administered in addition to metformin, as either first- or second-line treatment. The vildagliptin-metformin association seems to have favorable effects on beta-cell function and is characterized by good safety and tolerability profiles when compared with other antidiabetic agents. Of note, data available suggest that administration of fixed-dose combination products, together with the low incidence of adverse gastrointestinal events, may improve compliance and adherence of patients to therapy, resulting in an improved metabolic control.     

Study of the pharmacokinetic interaction of vildagliptin and metformin in patients with type 2 diabetes*

ABSTRACT

Objective: Metformin is widely used for treating patients with type 2 diabetes, often as first-line therapy; however, many patients with type 2 diabetes are unable to maintain adequate glycemic control with metformin alone. Vildagliptin, an orally active, potent and selective dipeptidyl peptidase IV (DPP-4) inhibitor, may represent an appropriate antihyperglycemic agent for combination with metformin to improve glycemic control in such patients. This study assessed the effects of coadministration of vildagliptin and metformin on the steady-state pharmacokinetics of each drug.

Research design and methods: In this open-label, single-center, randomized, three-period, three-treatment crossover study, 17 patients with type 2 diabetes received vildagliptin 100?mg once daily; metformin 1000?mg once daily; or vildagliptin 100?mg once daily plus metformin 1000?mg once daily. Blood samples for pharmacokinetic sampling were taken frequently on the final day (Day 5) of each treatment period. Lack of pharmacokinetic interaction was defined as the ratio of geometric mean (GMR) and 90% confidence interval (CI) for combination:monotherapy being within the range 0.80–1.25.

Results: Coadministration with metformin had no effect on vildagliptin AUC_0–24 (GMR, 0.94; 90% CI 0.90, 0.99) although there was an 18% decrease in vildagliptin C_max (GMR 0.82; 90% CI 0.73, 0.91). Coadministration with vildagliptin had no effect on metformin C_max (GMR 1.04; 90% CI 0.94, 1.16). but caused a 15% increase in AUC_0–24 (GMR 1.15; 90% CI 1.06, 1.25). Both monotherapies and combination therapy were well tolerated. Seven patients reported a total of 10 adverse events; none was serious.

Conclusions: Coadministration of vildagliptin and metformin had a small effect on the pharmacokinetics of each drug in patients with type 2 diabetes; however, this is not likely to be clinically relevant. This small, open-label trial suggests that vildagliptin could be coadministered with metformin without any dose adjustment for either agent.     

二甲双胍和吡格列酮对使用磺脲类药物治疗的2型糖尿病患者内皮功能的影响

目的:对比观察二甲双胍及吡格列酮对使用磺脲类药物治疗的2型糖尿病患者内皮功能的影响。方法:选择格列美脲单药治疗6个月以上2型糖尿病患者68例,随机分成2组:二甲双胍治疗组(A组)34例,在使用格列美脲的基础上加用二甲双胍(500mg,tid);吡格列酮治疗组(B组)34例,在使用格列美脲的基础上加用吡格列酮(15mg,bid);测定2组患者治疗前后的糖化血红蛋白、血脂、超敏C-反应蛋白、稳态模型胰岛素抵抗指数(HOMA-IR),同时利用超声检测肱动脉血流介导的内皮依赖性血管舒张功能(FMD)。结果:2组患者治疗后糖化血红蛋白、HOMA-IR均明显下降(P<0.05),FMD及高密度脂蛋白胆固醇均明显升高(P<0.05)。但2组患者治疗前后FMD的改变无差异(P>0.05)。结论:二甲双胍及吡格列酮均可改善2型糖尿病患者内皮依赖性舒张功能,但二者的作用无差异。