Hsieh Ching-Jung, Shen Feng-Chih
Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Clin Interv Aging. 2014 Nov 7;9:1905-11. doi: 10.2147/CIA.S72396. eCollection 2014.
To evaluate the durability of sitagliptin and to assess changes in clinical chronic complications following sitagliptin monotherapy for 48 months in elderly patients with type 2 diabetes mellitus (T2DM).
We enrolled 76 drug-naïve patients (40 women and 36 men; mean age: 71.3±11.7 years) with T2DM who received 25-100 mg of sitagliptin therapy from an outpatient clinic. The observational period for each patient was >48 months, beginning at the time sitagliptin therapy was initiated. The following were measured or performed at the beginning of each year: body mass index; serum total cholesterol, low-density lipoprotein, high-density lipoprotein; triglyceride levels; creatinine (Cr) levels; urine albumin and urine Cr; nonmydriatic fundusgraphy; and semiquantified neuropathy. The fasting plasma glucose and glycated hemoglobin (HbA1c) was measured every 3-6 months.
The change in HbA1c was significantly reduced after 6 months of therapy (7.1%±0.8% to 6.3%±0.2%). No changes in fasting plasma glucose, Cr, serum total cholesterol, triglyceride, low-density lipoprotein, high-density lipoprotein, body mass index, and microvascular complications were apparent. Using repeated measures to test the sequential changes in HbA1c from month 6 to month 48, the test of within-subjects effect was not significant (P=0.34).
Sitagliptin has a durable effect and stabilizes microvascular complication progression in elderly patients. This study can provide useful data for clinicians and health care professionals using sitagliptin monotherapy in the treatment of elderly patients with T2DM.
评估西他列汀的持久性,并评估老年2型糖尿病(T2DM)患者接受西他列汀单药治疗48个月后临床慢性并发症的变化。
我们纳入了76例初治的T2DM患者(40例女性和36例男性;平均年龄:71.3±11.7岁),这些患者在门诊接受25-100mg西他列汀治疗。每位患者的观察期>48个月,从开始西他列汀治疗时算起。每年年初测量或进行以下项目:体重指数;血清总胆固醇、低密度脂蛋白、高密度脂蛋白;甘油三酯水平;肌酐(Cr)水平;尿白蛋白和尿肌酐;免散瞳眼底照相;以及半定量神经病变。每3-6个月测量空腹血糖和糖化血红蛋白(HbA1c)。
治疗6个月后,HbA1c的变化显著降低(从7.1%±0.8%降至6.3%±0.2%)。空腹血糖、Cr、血清总胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白、体重指数和微血管并发症均无明显变化。使用重复测量来测试从第6个月到第48个月HbA1c的连续变化,受试者内效应检验不显著(P=0.34)。
西他列汀具有持久的疗效,并能稳定老年患者微血管并发症的进展。本研究可为临床医生和医疗保健专业人员在治疗老年T2DM患者时使用西他列汀单药治疗提供有用的数据。