Campbell I W, Menzies D G, Chalmers J, McBain A M, Brown I R
Diabetic Department, Victoria Hospital, Kirkcaldy, Fife, UK.
Diabete Metab. 1994 Jul-Aug;20(4):394-400.
Forty-eight diabetic subjects with diet-failed Type 2 mellitus, aged 40-69 years, were randomised to metformin (24 patients) or glipizide (24 patients) therapy, and followed prospectively for 12 months. Most subjects were obese. Metformin gave better fasting plasma glucose control compared to glipizide at 24 (p < 0.01), 36 (p < 0.05) and 52 weeks (p < 0.05) with a lower HbA1 concentration at 52 weeks (p < 0.05). Metformin treated patients lost weight whereas glipizide treated subjects gained weight. The weight change between the treatment groups reached significance at 4 weeks (p < 0.05) and was highly significant (p < 0.001) at 8, 12, 24, 36 and 52 weeks. There were no significant changes in either fasting plasma lipid or blood lactate levels in either the metformin or glipizide treated groups. Both drugs caused a similar reduction in albumin excretion rates. In conclusion, metformin gave better glycaemic control than glipizide, with weight loss rather than weight gain in obese Type 2 patients.
48名年龄在40 - 69岁、饮食控制失败的2型糖尿病患者被随机分为二甲双胍治疗组（24例）和格列吡嗪治疗组（24例），并进行了为期12个月的前瞻性随访。大多数受试者肥胖。在第24周（p < 0.01）、36周（p < 0.05）和52周（p < 0.05）时，二甲双胍在空腹血糖控制方面比格列吡嗪更好，且在第52周时HbA1浓度更低（p < 0.05）。二甲双胍治疗的患者体重减轻，而格列吡嗪治疗的受试者体重增加。治疗组之间的体重变化在第4周时具有显著性差异（p < 0.05），在第8、12、24、36和52周时差异高度显著（p < 0.001）。二甲双胍治疗组和格列吡嗪治疗组的空腹血脂或血乳酸水平均无显著变化。两种药物导致的白蛋白排泄率下降相似。总之，在肥胖的2型糖尿病患者中，二甲双胍在血糖控制方面优于格列吡嗪，且导致体重减轻而非增加。
