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目的观察非肥胖老年2型糖尿病(T2DM)患者(≥60岁)使用二甲双胍的疗效和安全性。方法对1996年1月至2006年12月在解放军总医院住院并使用二甲双胍的228例老年患者进行回顾性分析,比较肥胖和非肥胖患者使用二甲双胍治疗前后空腹血糖(FBG)、餐后血糖(PBG)、糖化血红蛋白(HbA1c)、血脂谱、肝肾功能、血乳酸、体重等指标的变化。结果肥胖和非肥胖老年T2DM患者使用二甲双胍治疗后FBG、PBG、HbA1c、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)均有显著降低(P<0.01),但两组间比较无统计学差异。体重、体质量指数(BMI)和甘油三酯(TG)在肥胖组和非肥胖组均有显著降低,且在肥胖组降低更明显(P<0.01)。两组治疗前后肝肾功能无显著差异,228例患者无乳酸酸中毒发生。结论无论是肥胖还是非肥胖的老年T2DM患者,应用二甲双胍治疗都能取得较好的降糖、调脂及减轻体重的效果,且使用安全。
Objective To investigate the efficacy and safety of metformin in non-obese elderly patients with type 2 diabetes (≥60 years). Methods A retrospective analysis was performed on 228 elderly patients hospitalized with PLA and using metformin from January 1996 to December 2006 in the People’s Liberation Army General Hospital. The levels of fasting blood glucose (FBG), postprandial blood glucose (PBG) ), Glycosylated hemoglobin (HbA1c), lipid profile, liver and kidney function, blood lactic acid, body weight and other indicators of change. Results The levels of FBG, PBG, HbA1c, total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) in obese and non-obese T2DM patients were significantly decreased after treatment with metformin (P <0.01) Statistical differences. Body weight, body mass index (BMI) and triglyceride (TG) decreased significantly in both obese and non-obese groups, and decreased more significantly in obese subjects (P <0.01). No significant difference between the two groups before and after liver and kidney function, 228 patients without lactic acidosis. Conclusion Both elderly patients with T2DM, obese and non-obese, are able to achieve good hypoglycemic, lipid-lowering and weight-reducing effects with metformin treatment and are safe to use.