Ziaee Amir, Esmailzadehha Neda, Honardoost Maryam
Amir Ziaee, Professor of Endocrinology, Padiatric Growth and Development Research Center, Institute of Endocrinology and Metabolism, ran University of Medical Sciences, Tehran, Iran.
Neda Esmailzadehha, General Practitioners, Metabolic Diseases Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
Pak J Med Sci. 2017 May-Jun;33(3):686-690. doi: 10.12669/pjms.333.12669.
All the aforementioned data have stimulated interest in studying other potential therapies for T1DM including noninsulin pharmacological therapies. The present study attempts to investigate the effect of adjunctive therapy with metformin and acarbose in patients with Type-1 diabetes mellitus.
In a single-center, placebo-controlled study (IRCT201102165844N1) we compared the results of two clinical trials conducted in two different time periods on 40 patients with Type-1 diabetes mellitus. In the first section, metformin was given to the subjects. After six months, metformin was replaced with acarbose in the therapeutic regimen. In both studies, subjects were checked for their BMI, FBS, HbA1C, TGs, Cholesterol, LDL, HDL, 2hpp, unit of NPH and regular insulin variations.
Placebo-controlled evaluation of selected factors has showna significant decrease in FBS and TG levels in the metformin group during follow up but acarbose group has shown substantial influence on two hour post prandial (2hpp) and regular insulin intake decline. Moreover, Comparison differences after intervention between two test groups has shown that metformin has had superior impact on FBS and HbA1C decline in patients. Nonetheless, acarbose treatment had noteworthy influence on 2hpp, TGs, Cholesterol, LDL, and regular insulin intake control.
The results of this experiment demonstrate that the addition of acarbose or metformin to patients with Type-1 diabetes mellitus who are controlled with insulin is commonly well tolerated and help to improve metabolic control in patients.
上述所有数据激发了人们对研究1型糖尿病（T1DM）其他潜在治疗方法的兴趣，包括非胰岛素药物治疗。本研究旨在探讨二甲双胍和阿卡波糖辅助治疗对1型糖尿病患者的影响。
在一项单中心、安慰剂对照研究（IRCT201102165844N1）中，我们比较了在两个不同时间段对40例1型糖尿病患者进行的两项临床试验结果。在第一阶段，给受试者服用二甲双胍。六个月后，治疗方案中的二甲双胍被阿卡波糖取代。在两项研究中，均对受试者的体重指数（BMI）、空腹血糖（FBS）、糖化血红蛋白（HbA1C）、甘油三酯（TGs）、胆固醇、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、餐后两小时血糖（2hpp）、中性鱼精蛋白锌胰岛素（NPH）单位和常规胰岛素变化进行了检查。
对选定因素的安慰剂对照评估显示，随访期间二甲双胍组的空腹血糖和甘油三酯水平显著降低，但阿卡波糖组对餐后两小时血糖和常规胰岛素摄入量的下降有显著影响。此外，两个试验组干预后的比较差异表明，二甲双胍对患者空腹血糖和糖化血红蛋白的下降影响更大。尽管如此，阿卡波糖治疗对餐后两小时血糖、甘油三酯、胆固醇、低密度脂蛋白和常规胰岛素摄入量的控制有显著影响。
本实验结果表明，在接受胰岛素治疗的1型糖尿病患者中添加阿卡波糖或二甲双胍通常耐受性良好，并有助于改善患者代谢控制。
