维格列汀和二甲双胍联合治疗2型糖尿病的疗效与安全性

Efficacy and safety of vildagUptin and metformin combination therapy in type 2 diabetes

维格列汀是一种二肽基肽酶4（DPP-4）抑制剂，常与二甲双胍合用治疗2型糖尿病。多个临床试验表明，维格列汀和二甲双胍合用可以有效降低2型糖尿病患者HbA1C、空腹血糖和餐后血糖，不增加体重，胃肠道耐受性好，而且低血糖发生率低。维格列汀通过增加血浆胰升糖素样肽1（GLP-1）促进胰岛素分泌，而二甲双胍除增加肝脏胰岛素敏感性，抑制肝糖输出外，尚有增强维格列汀增加GLP-1的作用。

Vildagliptin, a dipeptidyl peptidase-4 （DPP-4） inhibitor, is always used in combination with metformin. Data frnm multiple clinical trials showed that vi]dagliptin and metformin combination therapy can improve HbA1c, fasting blood glucose, and postprandial blood glucose without weight gain, good gastrointestinal （GI） tolerance, and no increase in the incidence of hypoglycemia. Vildagliptin increases plasma levels of glucagon-like peptide-1 （ GLP-1 ）. When glucose levels are above normal fasting levels, enhanced GLP-1 levels stimulate insulin secretion. Metformin has been shown to increase insulin sensitivity and inhibit hepatic glucose production. The effect of vildagliptin to increase plasma levels of intact GLP-1 was enhanced in patients receiving concomitant metformin.