诺和龙联合二甲双胍治疗肥胖患者2型糖尿病的疗效

Therapeutic Efficacy in Combined Administration of Repaglinide plus Metformin for Treatment of the Obese Patients with NIDDM

目的探讨诺和龙联合二甲双胍对肥胖患者 2型糖尿病 (NIDDM)的治疗作用。方法选择单用二甲双胍治疗 2个月后血糖仍未控制的 6 0例肥胖患者NIDDM患者随机分为三组 ,分别加用诺和龙、美吡哒或安慰剂干预 3个月 ,观察血糖、血脂、体重和低血糖反应等指标变化。结果诺和龙组空腹血糖 (FBG)、餐后 2h血糖 (2hPG)、糖化血红蛋白 (GHbA1C)、甘油三酯 (TG)、极低密度脂蛋白 (VLDL)和体重 (Wt)均较治疗前明显下降 ,差异有显著性 (均 P<0 .0 5 ) ;美吡哒组FBG、2hPG、GHbA1C较治疗前下降 ,差异有显著性 (均 P <0 .0 1) ,但TG、VLDL和Wt改变差异无显著性 (均P >0 .0 5 ) ,且后组低血糖反应发生率较前组 (4 5 %vs 15 %)明显增多 (χ2=4 .2 8,P <0 .0 5 )。结论诺和龙联合二甲双胍对于单用二甲双胍难以控制的肥胖患者NIDDM具有降血糖、调节血脂及减轻体重的作用 ,有一定的安全性 ;

ObjectivesTo explore the therapeutic efficacy in combined administration of repaglinide plus metformin for treatment of the obese patients with NIDDM.MethodsSixty obese patients with NIDDM whose blood glucose levels had not been controlled after treating singly with metformin for two months were randomly divided into three groups: ①Combined administration of metformin plus repaglinide;② metformin plus glibizide, or ③ using placebo.They were scheduled for three months, respectively. Changes in criteria such as blood levels of glucose and lipids, body weight(Wt)and hypoglycemic response were followed up before and after the treatment.Results①In group of metformin plus repaglinide ,fasting blood glucose(FBG),2h post meal glucose(2hPG),glycosylated HbAIC(GHbAIC),TG,VLDL and Wt all decreased significantly after treatment as compared with the results before treatment(P<0.05);whereas in group of metformin plus glibizide ,there were significant differences in FBG,2hPG and GHbAIC following therapy(P<0.01);but no obvious changes of TG,VLDL and Wt were observed (P>0.05).②The rate of hypoglycemic response in group② increased more significantly than in group①[45% vs 15%,χ 2=4.28,P<0.05].ConclusionCombined administration of repaglinide plus metformin in obese patients with NIDDM whose blood glucose levels have not been controlled by single metformin therapy reveals good therapeutic efficacy, with lowering of FBG, control of blood lipids levels and decrease in Wt. It is a reliable measure of safety.