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达格列净比格列本脲增加 2 型糖尿病患者的视网膜厚度:一项随机对照试验。

Dapagliflozin increases retinal thickness in type 2 diabetic patients as compared with glibenclamide: A randomized controlled trial.

机构信息

State University of Campinas Medical School, Campinas, SP, Brazil.

State University of Campinas Medical School, Campinas, SP, Brazil.

出版信息

Diabetes Metab. 2021 Nov;47(6):101280. doi: 10.1016/j.diabet.2021.101280. Epub 2021 Sep 16.

Abstract

AIM

In patients with type 2 diabetes mellitus (T2DM) a progressive thinning in the central retinal thickness (CRT) is mainly related to neuroretinal degeneration and occurs before the decline in visual acuity or capillary density. We investigated the change in CRT by optical coherence tomography (OCT) in T2DM patients after 12 weeks of treatment with dapagliflozin or glibenclamide.

METHODS

Ninety-seven patients (57 ± 7 years) with T2DM and clinical or subclinical atherosclerosis were randomized 1:1 to dapagliflozin (10 mg/day) or glibenclamide (5 mg/day) on top of metformin XR 1.5 g/day. OCT was obtained in all patients enrolled in the study, both at the time of randomization and at the end of the study.

RESULTS

Baseline and post-treatment values of fasting glucose and glycated hemoglobin were equivalent in the two arms. There was no difference in change in diabetic retinopathy status after therapy. The center subfield thickness changed by +2(6)μm in the dapagliflozin group and by -1(7) μm in the glibenclamide group (P = 0.001).

CONCLUSION

A short-term treatment with dapagliflozin may increase CRT as compared with equivalent glycemic control with glibenclamide.

摘要

目的

在 2 型糖尿病(T2DM)患者中,中央视网膜厚度(CRT)的逐渐变薄主要与神经视网膜变性有关,并且发生在视力或毛细血管密度下降之前。我们通过光学相干断层扫描(OCT)研究了在接受达格列净或格列本脲治疗 12 周后 T2DM 患者 CRT 的变化。

方法

97 名(57 ± 7 岁)患有 T2DM 和临床或亚临床动脉粥样硬化的患者,随机分为 1:1 接受达格列净(10 mg/天)或格列本脲(5 mg/天)治疗,同时服用二甲双胍 XR 1.5 g/天。所有入组患者在研究开始时和研究结束时均接受 OCT 检查。

结果

两组治疗前后空腹血糖和糖化血红蛋白的基线和治疗后值均相当。治疗后糖尿病视网膜病变状态无差异。达格列净组中心区视网膜厚度增加 2(6)μm,格列本脲组减少 1(7)μm(P=0.001)。

结论

与格列本脲等效的血糖控制相比,短期应用达格列净可能会增加 CRT。

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