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艾塞那肽与二甲双胍单药治疗新诊断2型糖尿病超重/肥胖患者的比较

Comparison of Exenatide and Metformin Monotherapy in Overweight/Obese Patients with Newly Diagnosed Type 2 Diabetes.

作者信息

Liu Jia, Hu Yanjin, Xu Yuan, Jia Yumei, Miao Li, Wang Guang

机构信息

Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, No. 8, Gongti South Road, Chaoyang District, Beijing 100020, China.

出版信息

Int J Endocrinol. 2017;2017:9401606. doi: 10.1155/2017/9401606. Epub 2017 Nov 20.

Abstract

AIMS

The present study assessed the therapeutic effect of exenatide and metformin as the initial therapy on overweight/obese patients with newly diagnosed type 2 diabetes (T2D).

METHODS

The prospective, nonrandomized, interventional study enrolled a total of 230 overweight or obese patients with newly diagnosed T2D who were administrated exenatide or metformin hydrochloride for 12 weeks.

RESULTS

224/230 patients, including 106 in the exenatide group and 118 in the metformin group, completed the 12-week treatment. Both exenatide and metformin significantly decreased the HbA1c levels in overweight/obese patients with newly diagnosed T2D (all < 0.05). The reduction in HbA1c and the proportion of patients with HbA1c < 7.0% (53 mmol/mol) were higher in the exenatide group than in the metformin group (all < 0.05). The exenatide treatment caused a greater decline in the body weight and BMI as compared to the metformin treatment (all < 0.01). The exenatide treatment ( = 0.41, < 0.01) and baseline HbA1c level ( = -0.84, < 0.01) were independent influencing factors for the decrease in HbA1c level.

CONCLUSIONS

For an initial therapy in overweight/obese patients with newly diagnosed T2D, exenatide causes a better glycemic control than metformin. This trial is registered with NCT03297879.

摘要

目的

本研究评估艾塞那肽和二甲双胍作为初始治疗对新诊断的2型糖尿病(T2D)超重/肥胖患者的治疗效果。

方法

这项前瞻性、非随机、干预性研究共纳入230例新诊断的T2D超重或肥胖患者,给予艾塞那肽或盐酸二甲双胍治疗12周。

结果

224/230例患者完成了12周治疗,其中艾塞那肽组106例,二甲双胍组118例。艾塞那肽和二甲双胍均显著降低了新诊断的T2D超重/肥胖患者的糖化血红蛋白(HbA1c)水平(均P<0.05)。艾塞那肽组HbA1c的降低幅度及HbA1c<7.0%(53 mmol/mol)的患者比例高于二甲双胍组(均P<0.05)。与二甲双胍治疗相比,艾塞那肽治疗导致体重和体重指数(BMI)下降幅度更大(均P<0.01)。艾塞那肽治疗(β=0.41,P<0.01)和基线HbA1c水平(β=-0.84,P<0.01)是HbA1c水平降低的独立影响因素。

结论

对于新诊断的T2D超重/肥胖患者的初始治疗,艾塞那肽比二甲双胍能更好地控制血糖。本试验已在ClinicalTrials.gov注册,注册号为NCT03297879。

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