二甲双胍血糖控制不佳的2型糖尿病患者联合应用沙格列汀或吡格列酮疗效观察

目的 探讨二甲双胍血糖控制不佳的2型糖尿病患者联合沙格列汀或吡格列酮的疗效.方法 选择2015年1月至2016年1月安徽医科大第二附属医院内分泌门诊符合入选条件的2型糖尿病患者70例,随机被分为两组,观察组35例采用沙格列汀+二甲双胍治疗,对照组35例患者采用吡格列酮+二甲双胍治疗,观察两组治疗前后的空腹血糖(FPG)、餐后2h血糖(2 hPG)、糖化血红蛋白(HbA1c)、空腹血清胰岛素水平、胰岛素抵抗指数(HOMA-IR)、体质指数(BMI)等.结果 与治疗前比较,治疗16周后观察组、对照组患者的FPG、餐后2 hPG与HbA1c明显降低,HOMA-IR改善,差异有统计学意义(P＜0.05);但两组间差异无统计学意义(P＞0.05).与治疗前比较,治疗16周后观察组BMI无明显变化,差异无统计学意义(P＞0.05),对照组患者BMI明显上升,差异有统计学意义(P＜0.05),两组间差异有统计学意义(P＜0.05).结论 沙格列汀或吡格列酮联合二甲双胍可有效控制2型糖尿病患者血糖、改善胰岛素敏感性,沙格列汀不增加体质量且不良反应小,联合二甲双胍治疗是一种安全可靠的治疗方法.

The observational study of saxagliptin or pioglitazone as add-on therapy in type 2 diabetes patients with inadequately controlled metformin monotherapy

Objective To assess the effieacy and safety of saxagliptin or pioglitazone in patients with type 2 diabetes mellitus inadequately controlled with metformin monotherapy.Methods Seventy T2DM patients inadequately controlled by metformin alone were recruited from outpatient center of our hospital from Jan 2015-Jan 2016 and randomized to observation group (saxagliptin combined with metformin) or control group (pioglitazone conbined with metformin) for 16 weeks.Fasting and postprandial blood glucose (FBG and 2 hPG),fasting insulin,HbAI c,HOMA-IR (homeostasis model assessment-insulin resistance),body mass index (BMI),episodes of hypoglycemia and adverse event were evaluated.Results After 16 weeks,FBG,2 hPG,HbAI C and HOMA-IR of each group significantly decreased(P ＜ 0.05),but no statistically significant difference was observed between the two groups (P ＞ 0.05).There was no change of BMI in observation group (P ＞ 0.05),while BMI increased in control group after 16-week treatment(P ＜0.05),and the difference between the two groups was statistically significant(P ＜ 0.05).Conclusion Saxagliptin or pioglitazone added to metformin provides statistically significant improvement in key parameters of glycemic control with low incidence of hypoglycemia and adverse effect.However,for BMI control,saxagliptin added to metformin demonstrates superiority,which is a safe and effective way to treat T2DM.