格列美脲与格列吡嗪治疗初诊超重的2型糖尿病疗效比较

目的：比较格列美脲与格列吡嗪对初诊超重的2型糖尿病（T2DM）的临床疗效。方法：T2DM患者64例，随机分为2组，格列美脲组31例，格列吡嗪组33例，疗程均为12周。观察2组血糖、胰岛素、血脂、体重指数（BMI）等的变化及不良反应。结果：2组降空腹血糖、餐后2小时血糖及糖化血红蛋白作用相似，对空腹胰岛素水平影响2组无差异。治疗12周后2组餐后2h胰岛素水平均升高，升高程度格列美脲组低于格列吡嗪组，差异有显著性（P〈0．01）。格列美脲组病人BMI下降，二组之间比较差异有显著性（P〈0．05）。低血糖反应发生率格列美脲组（3．2％）低于格列吡嗪组（12．1％），二组间差异有显著性（P〈0．05）。结论：格列美脲对初诊超重T2DM不仅能有效降低血糖且能降低BMI，较少的升高胰岛素水平。

Comparison of Clinical Effect of Glimgpiride and Glipizide in newly Diagnosed Overweight type 2 Diabetes Patients

Objective: To compare the clinical effects of glimgpiride and glipizide in treatment of newly diagnosed overweight type 2 diabetes mellitus.Methods: Sixty-four patients with type 2 diabetes mellitus were divided randomly into two groups as were glimgpiride group(n=31)and glipizide group(n=33);12 weeks later,the changes of blood glucose,Insulin,BMI,and adverse reaction in two groups were observed.Results: Similar decrease in fasting blood glucose,2 h postprandial blood glucose and HbA_(1C) were showed in both groups.There was no difference on the fast serum insulin between the two groups.Both 2 h postprandial serum insulin were higher than those before the treatment,but glimepiride group had less effects on increasing 2 h postprandial serum insulin than glipizide group(P<0.01).Glimepiride group decrease the BMI,with significant difference between the two groups(P<0.05).There was lower incidence of hypoglycemia by glimepiride(3.2%) than by glipizied(12.1%)(P<0.05).Conclusion: In newly diagnosed overweight type 2 diabetes mellitus glimepiride can effectively decrease blood glucose and BMI,but slightly increase serum insulin.