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二甲双胍治疗血糖控制不佳的2型糖尿病患者加用吡格列酮或西他列汀的对比研究

Comparative Study on Adding Pioglitazone or Sitagliptin to Patients with Type 2 Diabetes Mellitus Insufficiently Controlled With Metformin.

作者信息

Jameshorani Maryam, Sayari Saba, Kiahashemi Narjes, Motamed Nima

机构信息

Zanjan Metabolic Disease Research Center (ZMDR), Vali-e-asr Hospital, Zanjan University of Medical Science (ZUMS), Zanjan, Iran.

Department of Epidemiology, Zanjan University of Medical Science (ZUMS), Zanjan, Iran.

出版信息

Open Access Maced J Med Sci. 2017 Dec 12;5(7):955-962. doi: 10.3889/oamjms.2017.193. eCollection 2017 Dec 15.

Abstract

BACKGROUND

Diabetes mellitus is a progressive disorder that often requires combination therapy.

AIM

This study aimed to compare and study of add-on sitagliptin versus pioglitazone in patients with type 2 diabetes inadequately controlled with metformin.

METHODS

This 12-week, randomised, open-label and single centre study compared sitagliptin (100 mg daily, n = 80) and pioglitazone (30 mg daily, n = 80) in type 2 diabetic patients whose disease was not adequately controlled with metformin.

RESULTS

The mean change in HbA1c from baseline was -1.001 ± 0.83 with sitagliptin and -0.75 ± 1.20 with pioglitazone, and there were no significant difference between groups (P = 0.132). The mean change in fasting blood sugar (FBS) was -18.48 ± 33.32 mg/dl with sitagliptin and -20.53 ± 53.97 mg/dl with pioglitazone, and there were no significant difference between groups (P = 0.773). Sitagliptin caused 1.08 ± 2.39 kg decrease in weight, whereas pioglitazone caused 0.27 ± 2.42 kg increase in weight, with a between-group difference of 0.81 kg (P < 0.001). On the other hand, in sitagliptin group, there was greater improvement in lipid profile than pioglitazone group.

CONCLUSION

Sitagliptin and Pioglitazone demonstrated similar improvements in glycemic control in type 2 diabetes mellitus patients whose diabetes had been inadequately controlled with metformin. Nevertheless, sitagliptin was more effective than pioglitazone regarding lipid and body weight change.

摘要

背景

糖尿病是一种进展性疾病,通常需要联合治疗。

目的

本研究旨在比较和研究在二甲双胍治疗血糖控制不佳的2型糖尿病患者中加用西他列汀与吡格列酮的效果。

方法

这项为期12周的随机、开放标签、单中心研究,比较了西他列汀(每日100毫克,n = 80)和吡格列酮(每日30毫克,n = 80)在二甲双胍治疗血糖控制不佳的2型糖尿病患者中的疗效。

结果

西他列汀组糖化血红蛋白(HbA1c)较基线的平均变化为-1.001±0.83,吡格列酮组为-0.75±1.20,两组间差异无统计学意义(P = 0.132)。西他列汀组空腹血糖(FBS)的平均变化为-18.48±33.32毫克/分升,吡格列酮组为-20.53±53.97毫克/分升,两组间差异无统计学意义(P = 0.773)。西他列汀使体重下降1.08±2.39千克,而吡格列酮使体重增加0.27±2.42千克,组间差异为0.81千克(P < 0.001)。另一方面,西他列汀组的血脂改善情况优于吡格列酮组。

结论

在二甲双胍治疗血糖控制不佳的2型糖尿病患者中,西他列汀和吡格列酮在血糖控制方面表现出相似的改善效果。然而,在血脂和体重变化方面,西他列汀比吡格列酮更有效。

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