Mohan Dallumal Rita, Chua Siew Siang, Wu David Bin-Chia, Vethakkan Shireene Ratna
Department of Pharmacy, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia.
Int J Endocrinol. 2015;2015:950571. doi: 10.1155/2015/950571. Epub 2015 May 18.
Aim. The present study was conducted to determine the glycaemic effects of sitagliptin in type 2 diabetes patients. Methods. Data was collected from patient medical records of a major teaching hospital in Malaysia, from 2009 to 2012. Glycated hemoglobin (HbA1c) values prior to and up to 12 months after the initiation of sitagliptin were analysed. The change in HbA1c values was accounted for based on a generalized linear model generated using the Generalized Estimating Equations (GEE) method. Results and Discussion. Of the 457 patients, 53.6% were elderly and 81.4% were overweight. The mean HbA1c (standard deviation) before initiation of sitagliptin was 8.5 (1.4)%. This dropped to 7.7 (1.4)%, 3 to 6 months after initiation of sitagliptin, with a mean difference of 0.8% (95% confidence interval (CI): 0.7-1.0; P < 0.001). However, this value increased to 8.0 (1.7)% after 7 to 12 months on sitagliptin (P = 0.002) with a mean difference from baseline of 0.6% (95% CI: 0.4-0.7; P < 0.001). Conclusion. In routine clinical practice, sitagliptin produces a significant reduction in mean HbA1c (0.8%) within the first 6 months of use which corresponds to efficacy data obtained in controlled clinical trials. However, this reduction was lesser, 7 to 12 month later.
目的。本研究旨在确定西他列汀对2型糖尿病患者的血糖影响。方法。收集了马来西亚一家主要教学医院2009年至2012年患者的医疗记录数据。分析了开始使用西他列汀之前及之后长达12个月的糖化血红蛋白（HbA1c）值。基于使用广义估计方程（GEE）方法生成的广义线性模型对HbA1c值的变化进行分析。结果与讨论。在457名患者中，53.6%为老年人，81.4%超重。开始使用西他列汀之前的平均HbA1c（标准差）为8.5（1.4）%。开始使用西他列汀后3至6个月，该值降至7.7（1.4）%，平均差异为0.8%（95%置信区间（CI）：0.7 - 1.0；P < 0.001）。然而，使用西他列汀7至12个月后该值升至8.0（1.7）%（P = 0.002），与基线的平均差异为0.6%（95% CI：0.4 - 0.7；P < 0.001）。结论。在常规临床实践中，西他列汀在使用的前6个月内可使平均HbA1c显著降低（0.8%），这与在对照临床试验中获得的疗效数据相符。然而，7至12个月后这种降低幅度较小。
