二甲双胍联合西格列汀治疗2型糖尿病的疗效观察

目的 比较二甲双胍分别联合西格列汀及吡格列酮对2型糖尿病患者血糖、血脂、胰岛β细胞功能和胰岛素抵抗的影响。方法 120例新诊断的2型糖尿病患者随机分为西格列汀组与吡格列酮组,每组各60例,分别给予西格列汀和吡格列酮治疗,两组均联合二甲双胍治疗。治疗12周后对比两组患者的空腹血糖（fasting plasma glucose, FPG）、餐后2 h血糖（2 h postprandial plasma glucose, 2 h PG）、糖化血红蛋白（hemoglobin A1c, HbA1c）、空腹胰岛素（fasting insulin, FINS）、餐后2 h胰岛素（postprandial insulin, PINS）、胰岛β细胞功能指数（homeostasis model assessment of β-cell function, HOMA-β）及胰岛素抵抗指数（homeostasis model assessment of insulin resistance , HOMA-IR）、血脂水平、体重指数（body mass index, BMI）等变化。结果 12周治疗后,两组患者的FPG、2 h PG、HbA1c、FINS、PINS、HOMA-β、HOMA-IR、血脂、BMI均有改善,组内治疗前后的差异均有统计学意义（P<0.05）,西格列汀组治疗后的FPG、2 h PG、HbA1c、HOMA-IR、血脂及BMI均低于吡格列酮组,FINS、PINS、HOMA-β均高于吡格列酮组（P<0.05）。结论 二甲双胍分别联合西格列汀、吡格列酮的疗法均能够有效控制2型糖尿病患者的血糖、血脂水平,提高胰岛β细胞功能,降低胰岛素抵抗。与吡格列酮相比,西格列汀对血糖、血脂的控制和胰岛β细胞功能的改善更有优势。

Clinical efficacy observation of combination therapy with metformin and sitagliptin in type 2 diabetes

Objective To evaluate the clinical effects of sitagliptin and pioglitazone combined with metformin in treating type 2 diabetes, including plasma glucose, lipids, β-cell function and insulin resistance. Methods A total of 120 patients with type 2 diabetes were randomly divided into study group with sitagliptin and control group with pioglitazone, 60 patients in each group, both groups were combined with metformin. Fasting plasma glucose(FPG), 2 h postprandial plasma glucose(2 h PG), hemoglobin Alc(HbA1c),fasting insulin(FINS), postprandial insulin(PINS), homeostasis model assessment of β-cell function (HOMA-β), homeostasis model assessment of insulin resistance (HOMA-IR) ,lipids and body mass index(BMI) were compared between the two groups after 12 weeks treatments. Results After week 12, the levels of FPG, 2 h PG, HbA1c, HOMA-IR,BMI and lipids in the both groups were significantly lower than those before treatment(P<0.05), and FINS, PINS and HOMA-β was significantly improved in each group after treatment(P<0.05), especially in study group. The levels of FPG, 2 h PG, HbA1c, HOMA-IR,BMI and lipids in study group were significantly lower than control group(P<0.05), and the levels of FINS, PINS and HOMA-β were significantly higher than control group(P<0.05). Conclusions Combination therapy with sitagliptin/metformin or pioglitazone /metformin in type 2 diabetes can obviously control blood glucose level, ameliorate the state of insulin resistance and improve β-cell function. Sitagliptin in combination with metformin is proved to be more prominent.