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格列吡嗪控释片联合阿卡波糖或不联合阿卡波糖可改善新诊断 2 型糖尿病患者的血糖变异性。

Glipizide controlled-release tablets, with or without acarbose, improve glycaemic variability in newly diagnosed Type 2 diabetes.

机构信息

Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes; Shanghai Jiao Tong University Affiliated Sixth People's Hospital; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.

出版信息

Clin Exp Pharmacol Physiol. 2010 May;37(5-6):564-8. doi: 10.1111/j.1440-1681.2010.05361.x. Epub 2010 Jan 17.

DOI:10.1111/j.1440-1681.2010.05361.x
PMID:20082624
Abstract
  1. The aim of the present study was to compare the effects of glipizide controlled-release (CR) tablets monotherapy with that of glipizide CR tablets plus acarbose on glycaemic variability in newly diagnosed Type 2 diabetes (T2DM) patients using a continuous glucose-monitoring system (CGMS). 2. Forty newly diagnosed T2DM patients whose glycated haemoglobin A1c (HbA1c) levels ranged from 7.0% to 9.8% were randomized to either monotherapy or combination therapy. Overall glycaemic control and blood glucose variability were evaluated by CGMS parameters. 3. After 8 weeks treatment, fasting and postprandial blood glucose, HbA1c, glycated albumin (GA), mean blood glucose (MBG), mean amplitude of glycaemic excursions (MAGE), postprandial incremental area under the curve (AUC(pp)) and homeostasis model assessment of insulin resistance decreased significantly in both groups (P < 0.01). There was also a significant decrease in the mean of daily differences (MODD) in the combination therapy group. Mean changes in MBG, MAGE, MODD and AUC(pp) were significantly greater in the combination therapy group than in the monotherapy group (all P < 0.01), whereas no significant differences were found in the mean changes of HbA1c and GA. Multivariate regression analysis showed that the decrement in AUC(pp) was significantly associated with decreases in MAGE. 4. In conclusion, glipizide CR tablets alone or in combination with acarbose can improve overall blood glucose levels and glycaemic variability. Combination therapy using glipizide CR tablets and acarbose was more effective in reducing intraday and day-to-day glycaemic variability than glipizide CR tablet monotherapy.
摘要
  1. 本研究旨在通过连续血糖监测系统(CGMS)比较格列吡嗪控释片(CR)单药治疗与格列吡嗪 CR 片联合阿卡波糖治疗对新诊断 2 型糖尿病(T2DM)患者血糖变异性的影响。

  2. 将 40 例糖化血红蛋白(HbA1c)水平为 7.0%至 9.8%的新诊断 T2DM 患者随机分为单药组或联合治疗组。通过 CGMS 参数评估整体血糖控制和血糖变异性。

  3. 治疗 8 周后,两组空腹和餐后血糖、HbA1c、糖化白蛋白(GA)、平均血糖(MBG)、血糖波动幅度(MAGE)、餐后血糖增量曲线下面积(AUC(pp))和稳态模型评估的胰岛素抵抗均显著降低(P < 0.01)。联合治疗组的平均每日差值(MODD)也有显著下降。与单药组相比,联合治疗组 MBG、MAGE、MODD 和 AUC(pp)的平均变化明显更大(均 P < 0.01),而 HbA1c 和 GA 的平均变化无显著差异。多元回归分析显示,AUC(pp)的减少与 MAGE 的减少显著相关。

  4. 总之,格列吡嗪 CR 片单独或与阿卡波糖联合使用均可改善整体血糖水平和血糖变异性。与格列吡嗪 CR 片单药治疗相比,格列吡嗪 CR 片联合阿卡波糖治疗可更有效地降低日内和日间血糖变异性。

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