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拜糖平联合西格列汀治疗餐后血糖控制不佳2型糖尿病患者的临床疗效观察

来自:中国糖尿病杂志  编辑:张敏 陈景言 陈树等|点击数:|2015-08-26

  ·糖尿病临床研究· 

  【摘要】 目的 采用动态血糖监测系统(CGM)观察服用拜糖平餐后血糖控制不佳的T2DM患者联合服用西格列汀治疗后血糖波动情况。 方法 选择服用拜糖平150 mg/d 3个月,且餐后血糖控制不佳的新诊断T2DM患者35例,联合服用西格列汀100 mg/d 6个月,采用CGM观察血糖控制情况。 结果 联合服用西格列汀治疗后平均血糖水平[(8.77±1.68)vs(7.32±1.25) mmol/L]、平均血糖水平标准差[(1.73±0.37)vs(1.23±0.25) mmol/L]、平均血糖波动幅度(MAGE)[(4.21±0.94)vs(2.85±0.73) mmol/L],胰岛素曲线下面积(AUC)AUCIns 0~180[(47.4±11.6)vs(40.9±10.7)]均降低,AUCGLP-1 0~180[(15.7±4.5)vs (23.8±5.7)]升高。 结论 联合服用拜糖平和西格列汀可降低血糖波动幅度,改善餐后胰岛素分泌时相,减少餐后胰岛素分泌量。

  【关键词】 二肽基肽酶-4 抑制剂;α-葡萄糖苷酶抑制剂;肠促胰岛素;动态血糖监测

  Effect of additional Sitagliptin treatment on blood glucose in type 2 diabetic patients with unsatisfactory blood glucose control under treatment of AcarboseZHANG Min,CHEN Jing-yan,CHEN Shu,et al. Department of Eldly Endocrinology,Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital,Chengdu 610072,China

  Corresponding author:SUN Qin,E-mail:apropring@163.com

  【Abstract】 Objective To observe the effect of additional Sitagliptin treatment on blood glucose fluctuation in type 2 diabetic patients with unsatisfactory blood glucose control under treatment of Acarbose by continuous glucose monitoring (CGM). Methods A total of 35 patients with unsatisfactory blood glucose control under treatment of Acarbose 150 mg/d were enrolled in this study. Sitagliptin 100 mg/d was added to all the subjects,and follow up for 6 months. CGM was used for the blood glucose monitoring. Results After Sitagliptin treatment,The mean blood glucose level [(8.77±1.68)vs(7.32±1.25) mmol/L],the standard deviation of the mean blood glucose levels for the 24-hour period [(1.73±0.37)vs(1.23±0.25) mmol/L],mean amplitude of glycemic excursions (MAGE) [(4.21±0.94)vs(2.85±0.73) mmol/L],AUCIns 0~180values [(47.4±11.6)vs(40.9±10.7)] were all decreased. AUCGLP-1 0~180[(15.7±4.5)vs (23.8±5.7)] was increased. Conclusions The combined administration of both Sitagliptin and Acarbose could decrease blood glucose fluctuations,improve post prandial insulin secretion phase and decrease post prandial insulin level.

  【Key words】 Dipeptidyl peptidase-4 (DPP-4) inhibitor;α-glucosidase inhibitor;Incretin hormones;Continuous glucose monitoring(CGM)

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