格列美脲单用或联合二甲双胍控制不佳的2型糖尿病患者加用西格列汀的疗效观察

Efficacy of sitagliptin in patients with type 2 diabetes mellitus inadequately controlled on glimepiride alone or on glimepiride and metformin

目的评价单用格列美脲或联合二甲双胍控制不佳的2型糖尿病(T2DM)患者加用西格列汀的有效性和安全性。方法 40例T2DM患者中20例接受格列美脲单药治疗(4 mg/d),20例接受格列美脲联合二甲双胍(1500 mg/d)治疗,两组患者加用西格列汀(100 mg/d)治疗16周。结果两组患者加用西格列汀16周后糖化血红蛋白(HbA1C)、空腹血糖(FPG)、餐后2 h血糖(2 h PG)显著降低(P<0.01),空腹胰岛素(FIns)、稳态模型评估β细胞功能(HOMA-β)显著提高(P<0.05),加用西格列汀后低血糖风险低,胃肠道不良反应少。结论格列美脲单用或联合二甲双胍控制不佳的T2DM患者加用西格列汀100 mg/d后,能有效控制血糖,改善β细胞功能,且耐受性良好。

Objective To evaluate the efficacy and safety of a treatment with sitagliptin in patients with type 2diabetes who had inadequate glycemic control while on glimepiride alone or in combination with metformin. MethodsOf these 40 patients,20 were on glimepiride monotherapy and 20 were on glimepiride plus metformin combinationtherapy. All patients were provided sitagliptin therapy for 16 weeks. Results After 16 weeks,HbAlC,FPG and 2 h PGwere significantly reduced（P 〈 0.01）,while Fins and homeostasis model assessment-β were significantly increased （P〈 0.05）by the addition of sitagliptin. Low incidence of hypoglycemia and less gastrointestinal adverse reactions werefound in the addition of sitagliptin. Conclusion Sitagliptin 100 mg once daily may be able to significantly improveglycemic control and β -cell function in patients with type 2 diabetes who have inadequate glycemic control withglimepiride or glimepiride plus metformin therapy. The addition of sitagliptin is generally well tolerated.