低剂量二甲双胍与阿卡波糖对2型糖尿病患者血糖控制的效果比较

Glycemic Control with Low Dose Metformin vs Acarbose in Type 2 Diabetes

目的：比较低剂量二甲双胍与常规剂量阿卡波糖对非肥胖2型糖尿病患者血糖控制的效果。方法：选取本院本科室56名非肥胖2型糖尿病患者（体重指数BMI〈30），将其随机分为两组（A组n=28，B组n=28）。A组患者前3个月接受低剂量二甲双胍（500～750mg／d）单药治疗，后3个月转为接受常规剂量阿卡波糖（150—300mg／d）单药治疗。B组患者前3个月接受阿卡渡糖治疗，后3个月接受二甲双胍治疗，剂量与A组相同。检测两组基线、第3个月末和第6个月末的空腹血糖（FPG）、餐后2h血糖（2hPG）、糖化血红蛋白（HbA1c）、BMI、血压和血脂水平。结果：①低剂量二甲双胍显著降低了A组（P〈0．01）和B组（P〈0．05）患者的FPG水平；②低剂量二甲双胍降低了A组（P〈0．01）和B组（P〈0．01）患者的HbA1c水平。阿卡波糖只降低了B组的HbA1c水平（P〈0．05）；③低剂量二甲双胍和阿卡波糖单药治疗能降低餐后2hPG，但是不能达到治疗目标值。结论：低剂量二甲双胍与常规剂量阿卡波糖相比，前者对非肥胖2型糖尿病患者的血糖控制效果更佳。

Objective： To evaluate the glycemie control with low dose metformin vs acarbose in type 2 diabetes. Methods： 56 non-obese type 2 diabetic patients （ BMI 〈30） were randomly divided into two groups. Group A （n=28） was treated with low dose metformin （500-750 mg/d） for 3 months, and switched to acarbose （150-300 mg/d） for another 3 months. Group B （n=28） was treated with acarbose first, and then switched to low dose metformin . The fasting plasma glucose （FPG）, 2 h-postprandial blood glucose （2 h PG）, HbA1c, blood Lipid, blood pressure （Bp） and BMI were measured at baseline, the end of the 3rd month and the end therapeutic session. Results： ①Low dose metformin significantly decreased FPG levels in both groups A （P〈0.01）and B （P〈0.05）;② Low dose metformin significantly decreased HbA1c levels in both groups A （P〈0.01） and B （P〈0.01）, whereas acarbose decreased HbA1c levels only in group B （P〈0.05） ;③ Both low dose metformin and acarbose decreased 2 h PG levels, but did not reach the goal level. Conclusion： Low dose metformin therapy appears better than routine dosage acarbose therapy in improving glycemic control of nonobese diabetics.