瑞格列奈治疗中重度初诊2型糖尿病的疗效和安全性

Efficacy and safety of repaglinide in the treatment of severe newly diagnosed type 2 diabetic patients

目的探讨瑞格列奈对于未接受过口服降糖药治疗的中重度初诊2型糖尿病患者(HbA1c>8.5%)的疗效和安全性。方法入选未接受过口服降糖药治疗的中重度初诊2型糖尿病患者46例,随机分为2组。联合组23例用瑞格列奈和二甲双胍口服,单药组23例用瑞格列奈单独口服。观察治疗前后糖化血红蛋白(HbA1c)、空腹血糖(FBG)、餐后2 h血糖(PBG)、体质量、常规安全性指标和低血糖事件,并进行两组之间的比较。结果瑞格列奈单独或联合二甲双胍治疗后体质量没有明显变化,FBG降低2.8 mmol·L^(-1)(P<0.01),PBG降低5.2 mmol·L^(-1)(P<0.01),HbA1c降低3.9%(P<0.01),血糖的达标率为81.8%。联合组瑞格列奈中位数剂量每日3 mg,单药组瑞格列奈中位数剂量每日6 mg,联合组瑞格列奈用量显著低于单药组(P<0.05)。结论对于未接受过口服降糖药治疗的中重度(HbA1c>8.5%)初诊2型糖尿病患者,采用瑞格列奈单独或联合二甲双胍治疗能够有效和安全地降低HbA1c,降低FBG和PBG,以PBG为著;联合二甲双胍治疗能够减少瑞格列奈的剂量。

AIM To investigate the efficacy and safety of repaglinide therapy in newly diagnosed type 2 diabetic patients with HbA1c8.5%.METHODS Forty-six newly diagnosed type 2 diabetic patients were divided into 2 groups randomly.The combined group（23 patients） was given combined repaglinide and metformin orally.The monotherapy group（23 patients） was given repaglinide orally.After treatment for 16 weeks,the HbA1c,fasting blood glucose（FBG）, postprandial 2 h blood glucose（PBG）,weight,adverse drug reactions and hypoglycemic episodes were observed in both groups.RESULTS After the therapy with repaglinide,the weight wasn＇ t increased（P〉0.05）,the level of FBG was decreased by 2.8 mmol·L^-1（〈P0.01）,PBG was decreased by 5.2 mmol·L^-1（P〈0.01）,and HbA1c was decreased by3.9%（P〈0.01）.The attainment rate of HbA1c was 81.8%.The glucose was improved in both groups after the therapy,the weight wasn＇t increased.The control rate of HbA1c was 81.8%.The combined group was more effient than the monotherapy group,but the difference was not significant（P〉0.05）.The control rate of HbA1c was comparative. CONCLUSION In newly diagnosed type 2 diabetic patients with HbA1c〉8.5%,repaglinide therapy,whether or not combined with metformin,can safely and efficiently decrease HbA1c,FBG and PBG,especially PBG.The repaglinide therapy combined with metformin can decrease the dose of repaglinide.