Hajime Maiko, Okada Yosuke, Mori Hiroko, Arao Tadashi, Tanaka Yoshiya
The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan.
J UOEH. 2013 Sep 1;35(3):207-12. doi: 10.7888/juoeh.35.207.
It has become possible in Japan to use high-dose metformin for patients with type 2 diabetes. The aim of this retrospective study was to determine the effects and safety of metformin in elderly patients with type 2 diabetes. The study subjects (98 patients who were treated with metformin) were assigned into two groups: (Ⅰ) 59 patients who were younger, aged less than 65 years, and (Ⅱ) 39 patients who were elderly, aged more than 65 years. The primary endpoint was the change in glycosylated hemoglobin A1c (HbA1c) at 12 weeks. The secondary endpoints were the safety variables, including hypoglycemic events and adverse events. Although HbA1c decreased significantly in both group Ⅰ (-0.5%) and group Ⅱ (-0.9%), the difference between the two groups in the change in HbA1c was not significant. There were no incidences of hypoglycemia or adverse events in either group. Metformin improved glycemic control in the elderly patients as well as in the non-elderly patients. It is necessary to examine what dose of metformin and serum creatinin level (Cre), eGFR is appropriate for elderly patients.
在日本，已可以对2型糖尿病患者使用高剂量二甲双胍。这项回顾性研究的目的是确定二甲双胍对老年2型糖尿病患者的疗效和安全性。研究对象（98例接受二甲双胍治疗的患者）被分为两组：（Ⅰ）59例年龄小于65岁的较年轻患者，以及（Ⅱ）39例年龄大于65岁的老年患者。主要终点是12周时糖化血红蛋白A1c（HbA1c）的变化。次要终点是安全变量，包括低血糖事件和不良事件。虽然Ⅰ组（-0.5%）和Ⅱ组（-0.9%）的HbA1c均显著下降，但两组之间HbA1c变化的差异并不显著。两组均未发生低血糖或不良事件。二甲双胍在老年患者和非老年患者中均改善了血糖控制。有必要研究何种剂量的二甲双胍以及血清肌酐水平（Cre）、估算肾小球滤过率（eGFR）对老年患者是合适的。
