目的探讨二甲双胍联合维格列汀治疗初诊2型糖尿病(T2DM)的疗效及对血糖波动的影响。方法将64例初诊T2DM患者随机分为两组,分别采用二甲双胍+格列美脲(格列美脲组,32例)和二甲双胍+维格列汀(维格列汀组,32例),疗程均为12个月。比较两组...目的探讨二甲双胍联合维格列汀治疗初诊2型糖尿病(T2DM)的疗效及对血糖波动的影响。方法将64例初诊T2DM患者随机分为两组,分别采用二甲双胍+格列美脲(格列美脲组,32例)和二甲双胍+维格列汀(维格列汀组,32例),疗程均为12个月。比较两组患者血糖、血糖波动及不良反应情况。结果治疗后,两组的空腹血糖(FPG)、餐后2 h血糖(2 h PG)及糖化血红蛋白(Hb A1c)水平均明显下降,而维格列汀组2 h PG、Hb A1c水平显著低于格列美脲组(P<0.05);治疗后,两组胰高血糖素样肽-1(GLP-1)明显升高,胰岛素(INS)水平明显下降,而维格列汀组上述指标的改善更为显著(P<0.05);与格列美脲组比较,维格列汀组血糖达标时间明显缩短,24 h平均血糖(MBG)、平均血糖波动幅度(MAGE)均显著降低(P<0.05);两组低血糖事件、腹部不适的发生率无显著性差异(P>0.05)。结论与二甲双胍联合格列美脲相比,二甲双胍联合维格列汀治疗初诊T2DM患者具有更好降糖效果,可保护胰岛β细胞,且血糖波动小。展开更多
The aim of this study was to compare the difference of blood glucose(BG) fluctuation in the patients of type-2 diabetes mellitus(DM-2) with and without clinical diagnosed diabetic nephropathy(DN) by the continuous glu...The aim of this study was to compare the difference of blood glucose(BG) fluctuation in the patients of type-2 diabetes mellitus(DM-2) with and without clinical diagnosed diabetic nephropathy(DN) by the continuous glucose monitoring system(CGMS).Thirty DM-2 patients with clinical diagnosed DN and fifteen DM-2 patients without complication underwent continuous glucose monitoring for 3 days(72 h) by CGMS.The difference of daily glucose fluctuation in both groups was compared by the parameter of CGMS.The 24-h mean blood glucose (MBG),minimal BG(MIN-BG),area under curve of BG over 7.8(AUC7.8),percentage of time of BG over 7.8 (PT7.8),area under curve of BG over 11.1(AUC11.1),percentage of time of BG over 11.1(PT11.1),as well as mean of daily difference(MODD) were significantly increased in the group of DN,compared with those in the group of DM-2 without complication(all statistic probability P<0.05).No statistical significance of mean amplitude of glycaemic excursion(MAGE) was found.In the group of DN,MBG,standard deviation of blood glucose(SDBG),large amplitude of glycaemic excursion(LAGE),AUC7.8,PT7.8,AUC11.1,PT11.1,MAGE and MODD were(10.7±1.9) mmol/L,(2.5±1.3) mmol/L,(9.2±3.9) mmol/L,3.2±1.7,(81±18)%,1.2±1.0,(42±24)%, (5.8±2.5) mmol/L and(2.6±1.5) mmol/L,respectively.The study showed that the BG level of the patients with DN fluctuated throughout the day.MBG of the patients with DN was higher than that of the patients of DM-2 without complications,with the characteristics of long-lasting high BG period,dramatic instability during the day and especially high postprandial blood glucose.CGMS is a useful tool for physicians to know the details of the change of BG in the patients with DN.展开更多
文摘目的探讨二甲双胍联合维格列汀治疗初诊2型糖尿病(T2DM)的疗效及对血糖波动的影响。方法将64例初诊T2DM患者随机分为两组,分别采用二甲双胍+格列美脲(格列美脲组,32例)和二甲双胍+维格列汀(维格列汀组,32例),疗程均为12个月。比较两组患者血糖、血糖波动及不良反应情况。结果治疗后,两组的空腹血糖(FPG)、餐后2 h血糖(2 h PG)及糖化血红蛋白(Hb A1c)水平均明显下降,而维格列汀组2 h PG、Hb A1c水平显著低于格列美脲组(P<0.05);治疗后,两组胰高血糖素样肽-1(GLP-1)明显升高,胰岛素(INS)水平明显下降,而维格列汀组上述指标的改善更为显著(P<0.05);与格列美脲组比较,维格列汀组血糖达标时间明显缩短,24 h平均血糖(MBG)、平均血糖波动幅度(MAGE)均显著降低(P<0.05);两组低血糖事件、腹部不适的发生率无显著性差异(P>0.05)。结论与二甲双胍联合格列美脲相比,二甲双胍联合维格列汀治疗初诊T2DM患者具有更好降糖效果,可保护胰岛β细胞,且血糖波动小。
基金the Shanghai United Developing Technology Project of Municipal Hospitals (No.SHDC12006101)
文摘The aim of this study was to compare the difference of blood glucose(BG) fluctuation in the patients of type-2 diabetes mellitus(DM-2) with and without clinical diagnosed diabetic nephropathy(DN) by the continuous glucose monitoring system(CGMS).Thirty DM-2 patients with clinical diagnosed DN and fifteen DM-2 patients without complication underwent continuous glucose monitoring for 3 days(72 h) by CGMS.The difference of daily glucose fluctuation in both groups was compared by the parameter of CGMS.The 24-h mean blood glucose (MBG),minimal BG(MIN-BG),area under curve of BG over 7.8(AUC7.8),percentage of time of BG over 7.8 (PT7.8),area under curve of BG over 11.1(AUC11.1),percentage of time of BG over 11.1(PT11.1),as well as mean of daily difference(MODD) were significantly increased in the group of DN,compared with those in the group of DM-2 without complication(all statistic probability P<0.05).No statistical significance of mean amplitude of glycaemic excursion(MAGE) was found.In the group of DN,MBG,standard deviation of blood glucose(SDBG),large amplitude of glycaemic excursion(LAGE),AUC7.8,PT7.8,AUC11.1,PT11.1,MAGE and MODD were(10.7±1.9) mmol/L,(2.5±1.3) mmol/L,(9.2±3.9) mmol/L,3.2±1.7,(81±18)%,1.2±1.0,(42±24)%, (5.8±2.5) mmol/L and(2.6±1.5) mmol/L,respectively.The study showed that the BG level of the patients with DN fluctuated throughout the day.MBG of the patients with DN was higher than that of the patients of DM-2 without complications,with the characteristics of long-lasting high BG period,dramatic instability during the day and especially high postprandial blood glucose.CGMS is a useful tool for physicians to know the details of the change of BG in the patients with DN.
