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比较米格列醇与伏格列波糖联合应用和米格列醇加倍剂量治疗 2 型糖尿病患者的疗效。

Comparison of efficacy of concomitant administration of mitiglinide with voglibose and double dose of mitiglinide in patients with type 2 diabetes mellitus.

机构信息

Divisions of Diabetes and Metabolism and.

Innovative Diabetes Treatment, Department of Internal Medicine, Hyogo College of Medicine.

出版信息

J Diabetes Investig. 2011 Jun 5;2(3):204-9. doi: 10.1111/j.2040-1124.2010.00082.x.

Abstract

UNLABELLED

Aims/Introduction:  When monotherapy with an oral hypoglycemic agent (OHA) is not sufficiently effective for blood glucose control, combination therapy with OHA having different mechanisms of action might be indicated.

MATERIALS AND METHODS

In the present study, we compared the efficacy of two options in type 2 diabetes mellitus patients whose blood glucose had not been well controlled with mitiglinide (30 mg/day) alone. A total of 20 patients were included in the study and divided into two groups: group A, in which mitiglinide was given concomitantly with the α-glucosidase inhibitor voglibose (0.6 mg/day); and group B, in which a double dose of mitiglinide was given (60 mg/day). Twelve weeks after changing the medication, HbA1c, glycoalbumin and 1,5-anhydroglucitol (1,5-AG) were measured. In addition, at weeks 0 and 12, a meal tolerance test was carried out, and plasma glucose, insulin, glucagon, active glucagon-like peptide-1 (GLP-1) and total glucose-dependent insulinotropic polypeptide levels were measured.

RESULTS

The plasma level of 1,5-AG improved in both groups at week 12. In group A, the plasma insulin level significantly decreased and the plasma active GLP-1 level significantly increased during the meal tolerance test at week 12; thus, bodyweight significantly decreased only in group A.

CONCLUSIONS

Our findings suggested that concomitant administration of mitiglinide with voglibose could achieve better glycemic control, particularly in the postprandial period, without bodyweight gain and might have beneficial effects in type 2 diabetic patients at risk of macrovascular complications. (J Diabetes Invest, doi: 10.1111/j.2040-1124.2010.0082.x, 2011).

摘要

目的/引言:当口服降糖药(OHA)单药治疗不能有效控制血糖时,可能需要联合使用具有不同作用机制的 OHA 进行联合治疗。

材料和方法

在本研究中,我们比较了两种方案在血糖控制不佳的 2 型糖尿病患者中的疗效,这些患者单独使用米格列醇(30mg/天)。共有 20 例患者入组研究,分为两组:A 组,米格列醇联合α-葡萄糖苷酶抑制剂伏格列波糖(0.6mg/天);B 组,给予双倍剂量的米格列醇(60mg/天)。改变药物治疗 12 周后,测量糖化血红蛋白(HbA1c)、糖基化白蛋白和 1,5-脱水葡萄糖醇(1,5-AG)。此外,在第 0 周和第 12 周进行了口服糖耐量试验,测量了血浆葡萄糖、胰岛素、胰高血糖素、活性胰高血糖素样肽-1(GLP-1)和总葡萄糖依赖性胰岛素释放肽水平。

结果

两组患者在第 12 周时 1,5-AG 血浆水平均有所改善。在 A 组中,在第 12 周的口服糖耐量试验中,血浆胰岛素水平显著下降,活性 GLP-1 水平显著升高;因此,仅 A 组的体重显著下降。

结论

我们的研究结果表明,米格列醇联合伏格列波糖可实现更好的血糖控制,特别是在餐后期间,而不会导致体重增加,可能对有大血管并发症风险的 2 型糖尿病患者有益。(糖尿病研究与临床实践,doi:10.1111/j.2040-1124.2010.0082.x,2011)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/277a/4014920/7c3a39f93fa2/jdi-2-204-g1.jpg

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