|
|
|
| Clinical effect of Metformin combined with Sitagliptin in the treatment of patients with type 2 diabetes |
| LI Qiong1 FAN Jun-xiu1 PENG Wei1 PANG Dong-yue2 HU Jing-jing2 ZHANG Li-zhi2▲ |
1.Department of Medical Laboratory,Ji′an Hospital,Shanghai Oriental Hospital,Jiangxi Province,Ji′an 343000,China;
2.Department of Endocrinology,Jiangqiao Hospital in Jiading District,Jiading Branch of the First People′s Hospital of Shanghai City,Shanghai 201803,China |
|
|
|
|
Abstract Objective To investigate the clinical effect of Metformin combined with Sitagliptin in the treatment of patients with type 2 diabetes.Methods A total of 105 patients with type 2 diabetes who were treated in Shanghai Oriental Hospital from January 2017 to July 2020 who treated with Metformin alone and had poor glucose control effects were selected as the research objects.Among them,5 cases fell out,and 100 cases were finally enrolled.They were divided into group A(30 cases),group B(35 cases)and group C(35 cases)by random number table.Patients in group A continued to be treated with Metformin,patients in group B were treated with Metformin combined with Acarbose.Patients in group C were treated with Metformin combined with Sitagliptin.1,5-dehydroglucositol(1,5-AG),glycated hemoglobin(HbA1c),blood glucose ratio time within the target range(TIR)and the incidence of adverse reactions in three groups were compared before and after treatment.Results After intervention,the level of 1,5-AG in groups B and C were higher than that in group A at different visit periods,and the differences were statistically significant(P＜0.05).The 1,5-AG in group C was higher than that in group B,and the difference was statistically significant(P＜0.05).After intervention,HbA1c in group B and C were lower than group A,and the differences were statistically significant(P＜0.01).After intervention,there was no significant difference in HbA1c between group B and C(P＞0.05).After intervention,TIR of group B and C were higher than that of group A,and the differences were statistically significant(P＜0.01).After intervention,TIR in group C was higher than that in group B,and the difference was statistically significant(P＜0.01).The total incidence of adverse reactions in group A and C were lower than that in group B,and the differences were statistically significant(P＜0.05).There was no statistical significance in the total incidence of adverse reactions between group A and C(P＞0.05).Conclusion The combination of Metformin and Sitagliptin can significantly reduce HbA1c,and the patient′s blood glucose fluctuations will be smaller.It is a more optimized hypoglycemic treatment.
|
|
|
|
|
|
| [3] |
李洪超，徐菲，王藩.双时相门冬胰岛素联用二甲双胍治疗2型糖尿病的成本-效果分析[J].中国新药杂志，2011，20（21）：2163-2170.
|
| [1] |
Shaw JE，Sicree RA，Zimmet PZ.Global estimates of the prevalence of diabetes for 2010 and 2030[J].Diabetes Res Clin Pract，2010，87（1）：4-14.
|
| [2] |
Ji LN，Liu JM，Guo XH，et al.Glycemic control among patients in China with type-2 diabetes mellitus receiving oral drugs or injectables[J].BMC Public Health，2013，13：602.
|
| [4] |
World Health Organization.Definition，Diagnosis and Classification of Diabetes Mellitus and its Complications[M]WHO/NCD/NCS/99.2，Original：English，Distr.：General，1999.
|
| [5] |
中华医学会糖尿病学分会.中国血糖监测临床应用指南（2015年版）[J].中华糖尿病杂志，2015，7（10）：603-613.
|
| [6] |
Danne T，Nimri R，Battelino T，et al.International Consensus on Use of Continuous Glucose Monitoring[J].Diabetes Care，2017，40（12）：1631-1640.
|
| [7] |
Battelino T，Danne T，Bergenstal RM，et al.Clinical Targets for Continuous Glucose Monitoring Data Interpretation：Recommendations From the International Consensus on Time in Range[J].Diabetes Care，2019，42（8）：1593-1603.
|
| [8] |
贾伟平，周健，包玉倩.持续葡萄糖监测[M].上海：上海科学技术出版社，2017.
|
| [9] |
余霆，黄志刚.果糖胺与血糖、糖化血红蛋白的关系研究[J].华西医学，25（7）：1325-1327.
|
| [10] |
Nowak N，Skupien J，Cyganek K，et al.1，5-Anhydroglucitol as a marker of maternal glycaemic control and predictor of neonatal birthweight in pregnancies complicated by type 1 diabetes mellitus[J].Diabetologia，2013，56（4）：709-713.
|
| [11] |
Vermes I，Zeyen LJ，van Roon E，et al.The role of serum fructosamine as a screening test for gestational diabetes mellitus[J].Horm Metab Res，1989，21（2）：73-76.
|
| [12] |
Thanopoulou A，Karamanos B，Archimandritis A.Glycated hemoglobin，diabetes，and cardiovascular risk in nondiabetic adults[J].N Engl J Med，2010，362（21）：2030-2031.
|
| [13] |
Ruscitti P，Masedu F，Alvaro S，et al.Anti-interleukin-1 treatment in patients with rheumatoid arthritis and type 2 diabetes（TRACK）：A multicentre，open-label，randomised controlled trial[J].PLoS Med，2019，16（9）：e1002901.
|
| [14] |
Mehta SN，Schwartz N，Wood JR，et al.Evaluation of 1，5-anhydroglucitol，hemoglobin Alc，and glucose levels inyouth and young adults with type 1 dia betes and healthy controls[J].Pediatr Diabetes，2012，13（3）：278-284.
|
| [15] |
Buse JB，Freeman JL，Edelman SV，et al.Serum 1，5-anhydroglucitol（GlycoMark）：a short-term glycaemic marker[J].Diabetes Technol Ther，2003，5（3）：355-363.
|
| [16] |
Wang Y，Zhang YL，Wang YP.A study on the association of serum 1，5-anhydroglucitol levels and the hyperglycaemic excursions as measured by continuous glucose monitoring system among people with type 2 diabetes in China[J].Diabetes Metab Res Rev ，2012，28（4）：357-362.
|
| [17] |
Agarwal MM，Dhatt GS，Othman Y，et al.Gestational diabetes：an evaluation of serum fructosamine as a screening test in a high-risk population[J].Gynecol obstet Invest，2011，71（3）：207-212.
|
| [18] |
Kashiwagi A，Kasuga M，Araki E，et al.International clinical harmonization of glycated hemoglobin in Japan：from Japan Diabetes Society to National Glycohemoglobin Standardization Program values[J].J Diabetes Investig，2012，3（1）：39-40.
|
| [19] |
Yamanouchi T，Inoue T，Ogata E，et al.Post-load glucose measurements in oral glucose tolerance tests correlate well with 1，5-anhydroglucitol，an indicator of overall glycaemic state，in subjects with impaired glucose tolerance[J].Clin Sci（Lond），2001，101（3）：227-233.
|
| [20] |
邱文升.1，5-脱水山梨醇的基础与临床[J].中国糖尿病杂志，1997，（2）：41-43.
|
| [21] |
方京冲，史虹莉，杨秀芳，等.一种新的糖代谢检测指标——血清1，5-脱水山梨醇[J].中华内分泌代谢杂志，1998，（3）：34-38.
|
| [22] |
Matsuyama T，Katayama Y，Fujita S.Recent progress in evaluation of glycemic control byglicated and 1，5-AG[J].Rinsho Byori，1995，43（5）：445-448.
|
| [23] |
谷磊，张秀珍，雷涛.不同胰岛素治疗方案对1，5-脱水山梨醇水平的影响[J].中国临床医学，2007，14（5）：672-674.
|
| [24] |
Lu J，He J，Li M，et al.Predictive Value of Fasting Glucose，Postload Glucose，and Hemoglobin A1c on Risk of Diabetes and Complications in Chinese Adults[J].Diabetes Care，2019，42（8）：1539-1548.
|
|
|
|
