·糖尿病临床研究·

　　西格列汀或瑞格列奈联合甘精胰岛素在2型糖尿病治疗中的临床观察

　　余筱燕 赵廷启

　　【摘要】 目的 比较西格列汀联合甘精胰岛素和瑞格列奈联合甘精胰岛素治疗T2DM的疗效。 方法 将140例口服降糖药血糖控制不想理的T2DM患者随机分为观察组(西格列汀联合甘精胰岛素组)和对照组(瑞格列奈联合甘精胰岛素组)，治疗12周，观察HbA1c、FPG、2 hPG、BMI等有效性指标及胰岛素用量、低血糖发生情况。 结果 治疗后两组HbA1c、FPG、2 hPG相较于治疗前均有显著下降(P<0.05);两组HbA1c达标率分别为85.7%、87.2%，无显著差异，但观察组胰岛素用量比对照组减少11.4%，且BMI得到控制，低血糖发生率较少。 结论 西格列汀联合甘精胰岛素方案患者能有效控制体重，低血糖事件少见，在同等的HbA1c达标率下，所用的胰岛素剂量更少，是一种较好的联合治疗方案。

　　【关键词】 西格列汀;甘精胰岛素;瑞格列奈;2型糖尿病

Sitagliptin add-on Glargine Insulin versus Repaglinide add-on Glargine Insulin in the treatment of T2DM — A report of clinical observation YU Xiao-yan, ZHAO Ting-qi. Department of Endocrinology, The Affiliated Hospital of Ningbo University, Ningbo 315020, China

Corresponding author: YU Xiao-yan, E-mail: luciayu8536@163.com

　　【Abstract】Objective To compare the efficacy of sitagliptin add-on glargine insulin versus repaglinide add-on glargine insulin in treatment of T2DM patients. Methods The 140 T2DM patients who were inadequately controlled by oral anti-diabetic agent were randomized into observation group (sitagliptin add-on glargine insulin) or control group (repaglinide add-on glargine insulin), the duration of treatment was 12 weeks. The efficacy parameters, e.g. glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), 2-hour postprandial blood glucose (2hPG), body mass index (BMI), and dosage of insulin as well as hypoglycemia events were recorded to assess the result of treatment. Results After treatment, HbA1c, FPG, and 2hPG were significantly decreased compared to prior to treatment (P<0.05); HbA1c compliance rate was 85.7% in observation group versus 87.2% in control group, with no significant difference between, while the dosage of insulin in observation group was decreased by 11.4% compared to control group, with controlled BMI and low incidence of hypoglycemia. Conclusion The compliance to sitagliptin add-on glargine insulin is good. Sitagliptin add-on glargine insulin can effectively control blood glucose and body weight with low incidence of hypoglycemia and much less insulin dosage under the same HbA1c compliance rate. Sitagliptin add-on glargine insulin is an ideal combination therapy to treat T2DM.

　　【Key words】Sitagliptin; Gglargine insulin; Repaglinide; Diabetes mellitus, type