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二甲双胍用于超重或肥胖患者2型糖尿病的治疗

[Metformin in the treatment of type 2 diabetes in overweighted or obese patients].

作者信息

Martín Muñoz M C, Díaz J M, Muros Bayo J M, González Alvaro A, Costa Zamora P

机构信息

Centro de Salud Calesas, Hospital Universitario 12 de Octubre, Area 11, Madrid.

出版信息

An Med Interna. 2005 Dec;22(12):579-85. doi: 10.4321/s0212-71992005001200005.

Abstract

UNLABELLED

FUNDAMENTALS AND OBJECTIVES: [corrected] Diabetes is the disease that has suffered a greater increase in his incidence in the last years. Obesity is the most important risk factor to develop this disease and metformin is considered as a first line drug in overweighted diabetic patients. The aim of this study is to evaluate the use of metformin and the degree of control of the associated cardiovascular risk factors (CVRF) in patients suffering of type 2 diabetes and overweight or obesity.

PATIENTS AND METHODS

This is a transversal descriptive study over a random chosen group of 308 patients followed at primary care level. They were classified in four different groups depending on the treatment used to control them (diet, insulin, metformin and other oral antidiabetic drugs). They were evaluated upon the degree of control of the modifiable CVRF, the presence of complications and the metabolic control.

RESULTS

The average age was 69.6 years, 54% of the patients female. 36.6% followed treatment with metformin and 40.5% with sulfonylureas. The macrovascular percentage of affection was 19.4%. The most frequent CVRF was arterial hypertension (76%). The goal levels of control that were less in range were the levels of cLDL < 100 mg/dl and systolic blood pressure < 130 mmHg. Diabetic patients only treated with diet had a better control of fasten glycemia and HbA1c% than those ones treated with metformin (p < 0.001). The group treated with metformin showed levels of triglycerides (TG) significantly higher than those of the diet controlled group (p = 0.009) and insulin group (p < 0.001).

CONCLUSIONS

Metformin and sulfonylureas are used in a similar proportion in type 2 diabetics with overweight or obesity. There is a poor control of the majority of the CVRF in the diabetic population studied.

摘要

未标注

基本原理与目标:[已修正]糖尿病是近年来发病率增长幅度最大的疾病。肥胖是患此病最重要的风险因素,二甲双胍被视为超重糖尿病患者的一线用药。本研究旨在评估2型糖尿病合并超重或肥胖患者中二甲双胍的使用情况以及相关心血管危险因素(CVRF)的控制程度。

患者与方法

这是一项针对在基层医疗水平接受随访的308例随机选取患者的横断面描述性研究。根据用于控制病情的治疗方法(饮食、胰岛素、二甲双胍和其他口服降糖药),将他们分为四个不同组。对他们进行了可改变的CVRF控制程度、并发症的存在情况以及代谢控制方面的评估。

结果

平均年龄为69.6岁,54%的患者为女性。36.6%的患者接受二甲双胍治疗,40.5%的患者接受磺脲类药物治疗。大血管病变比例为19.4%。最常见的CVRF是动脉高血压(76%)。控制目标水平达标率较低的是cLDL<100mg/dl和收缩压<130mmHg。仅接受饮食治疗的糖尿病患者空腹血糖和糖化血红蛋白(HbA1c)%的控制情况优于接受二甲双胍治疗的患者(p<0.001)。接受二甲双胍治疗的组甘油三酯(TG)水平显著高于饮食控制组(p = 0.009)和胰岛素组(p<0.001)。

结论

在超重或肥胖的2型糖尿病患者中,二甲双胍和磺脲类药物的使用比例相近。在所研究的糖尿病患者群体中,大多数CVRF的控制情况较差。

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