阿卡波糖联合二甲双胍对老年难治性2型糖尿病患者血糖控制和胰岛功能的作用研究

目的探讨阿卡波糖联合二甲双胍在临床控制老年难治性2型糖尿病患者血糖和胰岛功能中的临床效果。方法收集2012年1月至2013年12月间524例老年难治性2型糖尿病患者随机分为两组,每组262例。对照组单用二甲双胍治疗,观察组在对照组的基础上联用阿卡波糖治疗。治疗3个月后,观察比较两组的疗效、血糖指标、胰岛功能及不良反应。结果观察组患者治疗总有效率显著高于对照组(P<0.05)。治疗后,两组的FBG、2h PBG、Hb A1C都显著低于治疗前,且观察组FBG、2h PBG、Hb A1C水平显著低于对照组(P<0.05)。治疗后,两组的Fins、HOMA-IR水平显著提高,而FCP、HOMA-B水平显著降低(P<0.05),治疗后观察组患者胰岛功能优于对照组。观察组药物性低血糖发生率显著低于对照组(P<0.05)。结论阿卡波糖联合二甲双胍在临床治疗中能有效控制老年难治性2型糖尿病患者的血糖和胰岛功能。

Effect of Acarbose Combined with Metformin on Blood Glucose Control and Islet Function in Elderly Patients with Refractory Type 2 Diabetes

Objective To evaluate the clinical effect of acarbose combined with metformin on the blood glucose control and islet function in elderly patients with refractory type 2 diabetes mellitus （T2DM）. Methods 524 elderly patients with refractory T2DM were randomly divided into two groups, with 262 cases in each group. The control group was treated with metformin, while the observation group was treated with acarbose combined with metformin. After 3 months of therapy, the clinical effect, glycemic indexes, islet function and adverse reactions were observed and analyzed. Results The total effective rate of observation group was significantly higher than that of control group （P 〈0.05）. After therapy, the FBG, 2hPBG, HbA1C of both group decreased significantly, and FBG, 2hPBG, HbA1C of observation group were significantly lower than those of control group （P〈0.05）. After therapy, the levels of Fins and HOMA-IR of both group increased significantly, and the levels of FCP and HOMA-B decreased significantly （P〈0.05）. The incidence of drug-induced hypoglycemia of observation group was significantly lower than that of control group （P 〈0.05）. Conclusions The combination therapy of acarbose and metformin for the treatment of elderly patients with refractory T2DM can effectively control the blood glucose and improve the islet function.