格列美脲与格列本脲治疗2型糖尿病比较

Glimepiride vs glibenclamide in treating type 2 diabetes

目的 :研究格列美脲治疗 2型糖尿病的疗效、不良反应及对胰岛素分泌的影响。方法 :6 7例 2型糖尿病分为 2组 ,格列美脲组 33例 ,初始剂量为1mg ,po ,qd ;格列本脲组 34例 ,初始剂量为2 .5mg ,po ,qd ;2组均根据血糖调整剂量 ,服药 12wk后测定血糖、胰岛素、糖化血红蛋白 (HbA1c)等变化。结果 :12wk治疗后格列美脲组空腹血糖、餐后 2h血糖和HbA1c值明显下降 [(2 .5±s 0 .4 )mmol·L- 1,(3.72± 0 .0 6 )mmol·L- 1和 (1.5 7±0 .0 5 ) % ,均P <0 .0 1];空腹胰岛素水平升高值无明显变化 [(0 .8± 0 .4 )mU·L- 1,P >0 .0 5 ];餐后 2h胰岛素水平明显升高 [(13.5± 2 .2 )mU·L- 1,P <0 .0 1],与格列本脲组比较差异均无显著意义 (P >0 .0 5 )。但格列本脲组餐后 2h胰岛素水平变化明显高于格列美脲组 [(37± 4 )mU·L- 1vs (34± 4 )mU·L- 1,P <0 .0 1) ]。结论 :格列美脲是一种安全有效的降糖药 。

AIM: To study the efficacy, adverse reactions of glimepiride in treating type 2 diabetes and its effect on insulin secretion. METHODS: Sixty seven patients with type 2 diabetes were divided into two groups.Thirty three patients(F 15, M 18; age(51± s 4a )of glimepiride group were treated with glimepiride 1 mg, po , qd at early dose and 34 patients(F 16, M 18; age (51±5) a) of glibenclamide group were treated with glibenclamide 2.5 mg, po , qd at early dose. The dose was regulated according to blood glucose. Blood glucose, insulin, and HbA1c were measured before and after 12 wk treatment. RESULTS: After 12 wk treatment in glimepiride group FBG, PBG and HbA1c lowered significantly ((2.5±0.4) mmol·L -1 ,(3.72±0.06) mmol·L -1 ,and (1.57±0.05)%, P <0.01); raised fasting insulin level was not significantly different((0.8+0.4)mU·L -1 , P>0.05 );post prandial 2 h insulin level raised significantly ((13.5±2.2)mU·L -1 , P < 0.01), these results were similar to those of glibenclamide group( P>0.05 ).But in glibenclamide group post prandial 2 h insulin level was significant higher than that in glimpiride group((37±4)mU·L -1 vs (34±4)mU·L -1 , P<0.01 ). CONCLUSION: Glimepiride is an effective and safe hypoglycemic agent. Glimepiride has stronger extrapancreatic mechanism of lowering blood glucose than glibenclamide.