摘要
目的观察二甲双胍单药治疗及联合DPP-4抑制剂沙格列汀对初发老年2型糖尿病患者胰岛B细胞功能的影响及血糖控制情况。方法选择初发老年2型糖尿病患者110例,随机分为沙格列汀联合二甲双胍治疗组(联用组)55例及二甲双胍单药治疗组(单用组)55例,测定2组治疗前及治疗12周后空腹血糖(FPG)、空腹胰岛素(FIns)、餐后2 h血糖(2h PG)、糖化血红蛋白(Hb A1c),同时计算胰岛素分泌指数(HOMA-β),并进行组间比较。结果 (1)单用组治疗12周后FPG由(8.13±1.12)mmol/L降至(7.23±2.05)mmol/L,2h PG由(12.26±2.72)mmol/L降至(10.46±1.13)mmol/L,Hb A1c由(8.20±2.28)%降至(6.94±2.03)%,差异均有统计学意义(P<0.05),FIns、HOMA-β较治疗前升高但差异无统计学意义(P>0.05)。(2)联用组治疗12周后FPG由(8.39±1.21)mmol/L降至(6.19±1.32)mmol/L,2h PG由(12.39±2.64)mmol/L降至(8.06±1.03)mmol/L,Hb A1c由(8.22±2.10)%降至(6.23±1.90)%,以上3项指标均较治疗前明显下降(P<0.05),且FIns、HOMA-β均高于同组治疗前(P<0.05)。(3)治疗12周后与单用组比较,联用组的FPG、2h PG以及Hb A1c均显著降低(P<0.05),且FIns、HOMA-β均增加(P<0.05)。结论在初发老年2型糖尿病患者中二甲双胍联合沙格列汀不仅可有效地控制血糖,而且可改善胰岛B细胞功能。
Objective To evaluate the effect of metformin combined with saxagliptin on B cell functions in elderly patients with newly diagnosed type 2 diabetes. Methods A total of 110 elderly patients with newly diagnosed type 2 diabetes were randomly assigned into metformin monotherapy group and metformin combined with saxagliptin group（ combination group）. The fasting plasma glucose（ FPG）,2-hour postprandial（ 2h PG）,fasting insulin（ FIns） and hemoglobin（ Hb A1c） were detected before and 12 weeks after treatment. The index of β cell function（ HOMA-β） was also calculated.Results（ 1） In metformin monotherapy group,the levels of FPG,2h PG,Hb A1 c were respectively reduced to（ 7. 23 ±2. 05） mmol / L,（ 10. 46 ± 1. 13） mmol / L and（ 6. 94 ± 2. 03） % after 12 weeks（ P〈0. 05）,and the levels of FIns and HOMA-β showed no statistical difference（ P〉0. 05）.（ 2） In combination group,the levels of FPG,2h PG and Hb A1 c were also obviously reduced after 12 weeks treatment（ P〈0. 05）. In addition,the levels of FIns and HOMA-β were higher than before（ P〈0. 05）.（ 3） Compared with monotherapy group,there were significant decreases in FPG,2h PG and Hb A1 c in the combination group,and significant increases in HOMA-β and FIns after 12 weeks＇ treatment（ P〈0. 05）.Conclusions Saxagliptin combined with metformin therapy can not only control the blood glucose efficiently but also improve the B cell function for the elderly patients with newly diagnosed type 2 diabetes mellitus.
出处
《实用老年医学》
CAS
2015年第3期232-234,共3页
Practical Geriatrics
