格列美脲单用或联合二甲双胍控制不佳2型糖尿病患者加用西格列汀疗效观察.docVIP

格列美脲单用或联合二甲双胍控制不佳2型糖尿病患者加用西格列汀疗效观察 　　[摘要] 目的 评价单用格列美脲或联合二甲双胍控制不佳的2型糖尿病（T2DM）患者加用西格列汀的有效性和安全性。 方法 40例T2DM患者中20例接受格列美脲单药治疗（4 mg/d），20例接受格列美脲联合二甲双胍（1500 mg/d）治疗，两组患者加用西格列汀（100 mg/d）治疗16周。 结果 两组患者加用西格列汀16周后糖化血红蛋白（HbA1C）、空腹血糖（FPG）、餐后2 h血糖（2 h PG）显著降低（P<0.01），空腹胰岛素（FIns）、稳态模型评估β细胞功能（HOMA-β）显著提高（P<0.05），加用西格列汀后低血糖风险低，胃肠道不良反应少。 结论 格列美脲单用或联合二甲双胍控制不佳的T2DM患者加用西格列汀100 mg/d后，能有效控制血糖，改善β细胞功能，且耐受性良好。 　　[关键词] 2型糖尿病；格列美脲；二甲双胍；西格列汀 　　[中图分类号] R587.1 [文献标识码] A [文章编号] 2095-0616（2013）15-19-03 　　Efficacy of sitagliptin in patients with type 2 diabetes mellitus inadequately controlled on glimepiride alone or on glimepiride and metformin 　　XU Qi ZHENG Xueying CHEN Shenren 　　Department of Endocrinology，the Second Affiliated Hospital of Shantou Medical University，Shantou 515041，China 　　[Abstract] Objective To evaluate the efficacy and safety of a treatment with sitagliptin in patients with type 2 diabetes who had inadequate glycemic control while on glimepiride alone or in combination with metformin. Methods Of these 40 patients，20 were on glimepiride monotherapy and 20 were on glimepiride plus metformin combination therapy. All patients were provided sitagliptin therapy for 16 weeks. Results After 16 weeks，HbA1C，FPG and 2 h PG were significantly reduced（P<0.01），while FIns and homeostasis model assessment-βwere significantly increased （P<0.05）by the addition of sitagliptin. Low incidence of hypoglycemia and less gastrointestinal adverse reactions were found in the addition of sitagliptin. Conclusion Sitagliptin 100 mg once daily may be able to significantly improve glycemic control and β-cell function in patients with type 2 diabetes who have inadequate glycemic control with glimepiride or glimepiride plus metformin therapy. The addition of sitagliptin is generally well tolerated. 　　[Key words] Type 2 diabetes mellitus；Glimepiride；Metformin；Sitagliptin 　　随着2型糖尿病（T2DM）病程的延长，使用单一降糖药常难以取得良好的血糖控制，故大多数患者需要联合用药[1]。二甲双胍或磺脲类是目前临床上广泛使用的口服降糖药，疗效确切，但仍有很多患者血糖难以达标，这时常需加用第三、四种口服降糖药（如噻唑烷二酮类）或加用胰岛素