Gregorio F, Ambrosi F, Filipponi P, Manfrini S, Testa I
Anti-Diabetic Unit, E. Profili General Hospital, Fabriano (AN), Italy.
Diabetes Metab. 1996 Feb;22(1):43-50.
We assessed the effect of adding low doses of metformin to sulfonylurea therapy in 76 elderly Type 2 diabetic patients by monitoring glycaemic control and blood lactate for one year. Metformin markedly improved glycaemic control. Fasting lactate concentrations were not affected and post-meal lactate peaks were minimally increased. Additional benefits included an improvement in some lipid parameters, a reduction in serum uric acid and a significant weight loss in overweight patients. Metformin was clinically well-tolerated. Instead of advanced age alone, renal function and/or any other age-related factor likely to contribute to lactate overproduction should be the basis for deciding on metformin therapy. No evidence indicated that metformin should be denied "a priori" to ageing Type 2 diabetic patients.
我们通过对76例老年2型糖尿病患者进行为期一年的血糖控制和血乳酸监测，评估了在磺脲类药物治疗基础上加用小剂量二甲双胍的效果。二甲双胍显著改善了血糖控制。空腹乳酸浓度未受影响，餐后乳酸峰值略有升高。其他益处包括一些血脂参数得到改善、血清尿酸降低以及超重患者体重显著减轻。二甲双胍在临床上耐受性良好。决定是否使用二甲双胍治疗时，不应仅依据高龄，而应以肾功能和/或任何其他可能导致乳酸生成过多的与年龄相关的因素为依据。没有证据表明应“先验地”拒绝老年2型糖尿病患者使用二甲双胍。
