目的 比较艾塞那肽与二甲双胍治疗新诊断2型糖尿病的疗效及其对血糖波动的影响。方法 将68例新诊断2型糖尿病患者随机分为2组,分别为二甲双胍组35例,艾塞那肽组33例。治疗12周,比较2组治疗前后空腹血糖(FBG),餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)、血脂、体重指数,以及血糖波动指标日内平均血糖波动幅度(MAGE)、最大血糖波动幅度(LAGE)、平均餐后血糖波动幅度(MPPGE)的变化。结果 治疗12 周后,两组FBG、2 h PG、HbA1c、血糖波动指标较治疗前均明显下降,两组治疗后无统计学差异;两组治疗后三酰甘油(TG)较治疗前明显降低(P<0.05),二甲双胍组(1.88±0.57)mmol/L,艾塞那肽组(1.58±0.21)mmol/L,相比二甲双胍组,艾塞那肽组下降更为明显(P<0.05);体重指数艾塞那肽组治疗前体重(25.14±2.21)kg/m2,治疗后(23.16±1.46)kg/m2,治疗前后比较具有统计学差异(P<0.05)。结论 艾塞那肽与二甲双胍对新诊断2型糖尿病控制血糖效果具有同等的疗效,艾塞那肽在降低三酰甘油及体重方面更为显著。
Abstract
Objective To study the effect of exenatide and metformin on treatment of newly diagnosed type 2 diabetes.Methods 68 patients with newly diagnosed type 2 diabetes were randomly divided into two groups: metformin group (35 patients) and exenatide group (33 patients) and were treated for 12 weeks. The changes in FBG, 2 h PG, HbA1c, CHO, TG, LDL, BMI, MAGE, LAGE and MPPGE were observed in two groups.Results After 12 weeks of treatment, in two groups the levels of FBG, 2 h PG, HbA1c, MAGE, LAGE and MPPGE showed significant decrease (P<0.05), and no significant difference was observed. After treatment,TG was significantly lower than before treatment in the two groups (P<0.05), TG was (1.88±0.57) mmol/L in metformin group and (1.58±0.21) mmol/L in exenatide group; compared with metformin group, in the exenatide group it decreased more significantly (P<0.05). In exenatide group, body mass index (BMI) was (25.14±2.21) kg/m2 before treatment and (23.16±1.46) kg/m2 after treatment, BMI was significantly decreased after treatment (P<0.05).Conclusions In patients with newly diagnosed type 2 diabetes, exenatide and metformin can remarkably control blood glucose. The effect of exenatide on body weight and TG are better than that of metformin.
关键词
艾塞那肽 /
二甲双胍 /
2型糖尿病 /
血糖波动
Key words
exenatide /
metformin /
type 2 diabetes /
glucose fluctuation
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Sierra P R, Riobó S P, Vázquez M C. Effects of exenatide lar in type 2 diabetes mellitus and obesity [J]. Nutr Hosp, 2014, 31(1): 292-298.
[2] 李 静,陈 宏,张 桦,等.艾塞那肽对间歇性高糖环境下胰岛INS-1细胞的保护作用[J]. 解放军医学杂志, 2011, 36(4): 379-381.
[3] Gallwitz B. Glucagon-like peptide-1 analogues for Type 2 diabetes mellitus: current and emerging agents [J]. Drugs,2011,71(13):1675-1688.
[4] Bhavsar S,Mudaliar S,Cherrington A. Evolution of exenatide as a diabetes therapeutic[J].Curr Diabetes Rev,2013,9(2):161-193.
[5] Pujante A P,Hellín G,Roman L M,et al. Metabolic control and weight loss in patients with obesity and type 2 diabetes mellitus, treated with exenatide [J]. Med Clin (Barc),2012,139(13):572-578.
[6] Torimoto K, Okada Y, Mori H, et al. Relationship between fluctuations in glucose levels measured by continuous glucose monitoring and vascular endothelial dysfunction in type 2 diabetes mellitus [J]. Cardiovasc Diabetol, 2013,12(1):1-7.
[7] Lv X, Zhang X, Zhang Y, et al. The impact of blood glucose fluctuation on endothelial dysfunction and severity of stenosis in acute coronary syndrome patients [J]. Exp Clin Cardiol,2014,20(1):1747-1761.
[8] Huang J,Zhang X,Li J,et al.Impact of glucose fluctuation on acute cerebral infarction in type 2 diabetes[J]. Can J Neurol Sci,2014,41(4):486-492.
[9] Jiao X M,Zhang X G,Xu X U,et al. Blood glucose fluctuation aggravates lower extremity vascular disease in type 2 diabetes [J]. Eur Rev Med Pharmacol Sci,2014,18(14):2025-2030.
[10] Matsuo K,Nambu T,Matsuda Y,et al.Evaluation of the effects of exenatide administration in patients with type 2 diabetes with worsened glycemic control caused by glucocorticoid therapy [J]. Intern Med,2013,52(1):89-95.