沙格列汀和(或)二甲双胍治疗对初诊2型糖尿病患者胰岛β细胞功能的影响

Saxagliptin add-on to metformin improves βcell functions in newly diagnosed patients with type 2 diabetes

目的观察沙格列汀联合二甲双胍及二甲双胍单药治疗对初诊2型糖尿病患者胰岛β细胞功能的影响。方法初诊2型糖尿病患者66例随机分为沙格列汀联合二甲双胍治疗组(A组)33例、二甲双胍单药治疗组(B组)33例,测定治疗前及治疗24周后空腹血糖(FPG)、空腹胰岛素(FIns)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1C)、HOMA-β及HOMA-IR等。结果(1)治疗后两组受试者FPG、2hPG及HbA1C均较治疗前下降(P<0.05),A组患者上述指标均低于B组(P<0.05);(2)治疗后两组受试者HOMA-β增加、HOMA-IR下降(P均<0.05),但A组HOMA-β高于B组(P<0.05)、而两组HOMA-IR无差异。结论对初诊2型糖尿病患者进行沙格列汀联合二甲双胍治疗可有效控制血糖,且沙格列汀可改善胰岛β细胞功能。

Objective To evaluate the effect of saxagliptin in combination with mefformin on [3 cell functions in newly diagnosed patients with type 2 diabetes. Methods It was a randomized observational study. At baseline,a total of 66 newly diagnosed patients with type 2 diabetes were randomly assigned to metformin plus saxagliptin therapy（group A,n=33） or metformin monotherapy（group B,n=33）. The observational period lasted for 24 weeks. Repeated measures were utilized to evaluate changes from baseline in fasting plasma glucose（FPG）,2-hour postprandial plasma glucose （2hPG）, serum insulin concentrations, hemoglobin A1C（HbA1C）,homeostasis model assessment index of insulin resistance （HOMA-IR） and β cell function （HOMA- [3）.HOMA- β was compared between group A and B. Results The levels of FPG,2hPG, HbA1C and HOMA-IR decreased significantly in both groups 24 weeks after the initiation （P 〈 0.05）.HOMA- β increased significantly in both groups （P 〈 O.05）.Compared with group B, there was significant reductions in FPG, 2hPG and HbA1C in group A,and increase in HOMA- β （P 〈 0.05）. Conclusion Saxagliptin as an add-on therapy to metformin not only benefits glucose control but also improves β cell function.