生活方式干预同期口服二甲双胍治疗糖尿病前期患者效果分析

Effect analysis of lifestyle intervention and simultaneous oral administration of metformin in the treatment of pre-diabetes patients

目的糖尿病前期是介于糖尿病和正常血糖的一种中间状态,是糖尿病发展的必经阶段。本研究针对糖尿病前期患者采取日常生活方式干预和同时口服二甲双胍干预治疗的临床结果进行对比,确定延缓糖尿病进展的有效措施。方法选取2016-09-01-2016-10-20山东省东营市河口区六合街道卫生院≥60岁老年人检测出糖尿病前期260例患者作为研究对象,按照患者意愿是否同意口服药物分为生活方式组和二甲双胍组,每组130例。随访时间为2年,分析患者血糖空置情况和自我管理效果评价。结果生活方式组有20例进展为糖尿病,二甲双胍组有5例进展为糖尿病,差异有统计学意义,P<0.05。干预后生活方式组和二甲双胍组空腹血糖比较,3个月为(5.78±0.50)和(5.60±0.55)mmol/L,t=2.761,P<0.01;6个月为(5.77±0.48)和(5.63±0.42)mmol/L,t=2.503,P<0.05;12个月为(5.78±0.42)和(5.58±0.46)mmol/L,t=3.661,P<0.01;18个月为(5.87±0.38)和(5.53±0.24)mmol/L,t=8.625,P<0.01;24个月为(6.10±0.32)和(5.58±0.25)mmol/L,t=14.600,P<0.01,差异均有统计学意义。餐后2h血糖比较,6个月为(8.46±1.28)和(7.81±1.25)mmol/L,t=4.142,P<0.01;12个月为(8.46±1.22)和(7.68±1.38)mmol/L,t=4.828,P<0.01;18个月为(8.38±1.33)和(8.52±1.17)mmol/L,t=0.901,P<0.01;24个月为(8.15±1.45)和(7.90±1.23)mmol/L,t=1.499,P<0.01,差异均有统计学意义。干预后,二甲双胍组遵从医嘱(χ2=5.731,P<0.05)、糖尿病饮食(χ2=5.591,P<0.05)、规律运动(χ2=5.417,P<0.05)和减低体质量(χ2=8.561,P<0.01)等指标均优于生活方式组,差异有统计学意义。结论生活方式干预同时口服二甲双胍在控制血糖、减轻体质量、降低血脂和防止糖尿病前期进展为糖尿病方面优于单纯生活方式干预。

OBJECTIVE Pre-diabetes is an intermediate state between diabetes and normal blood glucose,which is a necessary stage in the development of diabetes.This study compares the efficacy of daily lifestyle intervention and oral metformin intervention in the treatment of patients with prediabetes,and determines the effective measures to delay the progression of diabetes.METHODS From September 1,2016 to October 20,2016,260 cases of patients with pre-diabetes detected in Liuhe street health center of Hekou district,Dongying City were selected as subjects.According to whether the patients agreed to take oral drugs,they were divided into lifestyle group and metformin group,with 130 cases in each group.The patients were followed up for 2 years to analyze their blood glucose vacancy and self-management effect evaluation.RESULTS In the lifestyle group,20 patients developed diabetes,in the metformin group,5 patients developed diabetes,and the difference was statistically significant(P<0.05).After the intervention,the fasting blood glucose levels in the lifestyle group and metformin group were(5.78±0.50)and(5.60±0.55)mmol/L,respectively t=2.761,P<0.01.They respectively were(5.77±0.48)and(5.63±0.42)mmol/L at 6 months,t=2.503,P<0.05;(5.78±0.42)and(5.58±0.46)mmol/L at 12 months,t=3.661,P<0.01;(5.87±0.38)and(5.53±0.24)mmol/L at 18 months,t=8.625,P<0.01;and(6.10±0.32)and(5.58±0.25)mmol/L at 24 months,t=14.600,P<0.01.All the differences were statistically significant.Their blood glucose at 2 hafter meal respectively were(8.46±1.28)and(7.81±1.25)mmol/L,t=4.142,P<0.01;(8.46±1.22)and(7.68±1.38)mmol/L a t12 months,t=4.828,P<0.01;(8.38±1.33)and(8.52±1.17)mmol/L at 18 months,t=0.901,P<0.01;(8.15±1.45)and(7.90±1.23)mmol/L at24 months,t=1.499,P<0.01.All the differences were statistically significant.After the intervention,the metformin group was better than the lifestyle group in following the doctor′s advice(χ2=5.731,P<0.05),diabetic diet(χ2=5.591,P<0.05),regular exercise(χ2=5.417,P<0.05)and decreased body mass(χ2=8.561,P<0.01),with statistically significant differences.CONCLUSION At the same time,taking metformin orally is better than simple lifestyle intervention in controlling blood glucose,reducing body mass,lowering blood lipid and preventing the development of diabetes.