论文部分内容阅读
目的比较米格列奈与瑞格列奈对新诊断2型糖尿病患者(T2DM)在糖代谢、心血管危险因子、氧化应激方面的影响,了解米格列奈药物的短期和中期疗效。方法 2010年4月至2011年1月在我院新诊断90例T2DM患者按随机数字表法分为A、B组(n=45),A组给予瑞格列奈+二甲双胍,B组给予米格列奈+二甲双胍,应用动态血糖监测系统(CGMS)记录3 d内的动态血糖水平和波动趋势,之后12周定期随访相应指标。结果 2组治疗后3 d,空腹血糖、3餐后平均血糖(MBG)及日内血糖平均水平均较治疗前降低,B组餐后1 h及2 h MBG降幅大于A组(P<0.05),平均血糖波动幅度(MAGE)小于A组(P<0.05);12周后,2组空腹及餐后1、2 h血糖均明显降低,B组降幅大于A组;空腹及餐后1、2 h胰岛素(FINS、1 h INS、2 h INS)不同程度升高,B组1 h INS、2 h INS增幅大于A组;B组降低HbA1c幅度大于A组;2组均能降低胰岛素抵抗指数(HOMA-IR)、升高胰岛素敏感指数(ISI),B组优于A组(P<0.05);B组低血糖发生人次低于A组。2组均能不同程度降低总胆固醇(TC)、甘油三酯(TG)、纤维蛋白原(FG)水平,升高高密度脂蛋白胆固醇(HDL-c)水平,2组对纤溶酶原激活物抑制因子-1(PAI-1)下降作用均不明显(P>0.05);B组降低超氧化物歧化酶(SOD)、升高丙二醛(MDA)优于A组(P<0.05)。结论米格列奈与瑞格列奈均能在短期内降低新诊断T2DM患者的血糖,但米格列奈组平均血糖波动幅度小;中期治疗后,与瑞格列奈比较,米格列奈能更好地提高糖化血红蛋白达标率,降低低血糖发生率,改善氧化应激因子。
Objective To compare the effects of mitiglinide and repaglinide on newly diagnosed type 2 diabetes mellitus (T2DM) in terms of glucose metabolism, cardiovascular risk factors and oxidative stress and to understand the short- and medium-term effects of mitiglinide. Methods From April 2010 to January 2011, 90 newly diagnosed T2DM patients in our hospital were divided into A and B groups (n = 45) according to random number table. A group received repaglinide + metformin, and group B Gliclazide plus metformin. The dynamic blood glucose level and fluctuation trend within 3 days were recorded by CGMS. The corresponding indexes were followed up regularly for 12 weeks. Results After 3 days of treatment, fasting blood glucose, mean postprandial blood glucose (MBG), and average daily blood glucose levels were lower in both groups than those before treatment. In group B, the MBG decrease at 1 and 2 h postprandial was significantly greater than that in group A (P <0.05) The mean blood glucose fluctuation (MAGE) was lower in group A than in group A (P <0.05). After 12 weeks, the fasting blood glucose and blood sugar at 1 and 2 h were significantly decreased in group B and in group B, Insulin (FINS, 1 h INS, 2 h INS) increased to different extents, INS 1 h and INS INS 2 h in group B increased more than that in group A; HbA1c amplitude decreased significantly in group B compared with group A; both groups decreased insulin resistance index (HOMA -IR), increased insulin sensitivity index (ISI), group B was better than group A (P <0.05); group B was lower than group A in the incidence of hypoglycemia. The levels of total cholesterol (TC), triglyceride (TG), fibrinogen (FG) and the level of high-density lipoprotein cholesterol (HDL-c) (P <0.05). The decrease of superoxide dismutase (SOD) and malondialdehyde (MDA) in group B was better than that in group A (P <0.05) . Conclusion Both mitiglinide and repaglinide can reduce the blood glucose in newly diagnosed T2DM patients in a short term, but the average blood glucose fluctuation in the mitiglinide group is small. After mid-term treatment, compared with repaglinide, Can better improve the rate of glycosylated hemoglobin, reduce the incidence of hypoglycemia, improve oxidative stress factor.