Comparison of glycaemic control and cardiovascular risk profile in patients with type 2 diabetes during treatment with either repaglinide or metformin
Comparison of glycaemic control and cardiovascular risk profile in patients with type 2 diabetes during treatment with either repaglinide or metformin
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DOI：
10.1016/s0168-8227(03)00057-3
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发表时间：
2003-06-01
影响因子：
5.1
通讯作者：
Fogari, R
中科院分区：
文献类型：
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作者：
Derosa, G;Mugellini, A;Fogari, R
目的：比较瑞格列奈或二甲双胍治疗12个月后2型糖尿病患者的血糖控制和心血管风险特征。研究设计和方法：这是一项在n = 112例既往未接受口服降糖药治疗的控制不佳的2型糖尿病患者中进行的开放、非对照、随机化研究。开始接受瑞格列奈或二甲双胍治疗的患者进入8周滴定期（优化剂量：瑞格列奈，2-4 mg/天;二甲双胍，1500-2500 mg/天），随后进入12个月治疗期。在基线和治疗期结束时测定血糖控制和心血管风险因素。结果：平均值（S.D.）瑞格列奈组的最终药物剂量为3（+/-1）mg/天，二甲双胍组为2000（+/-500）mg/天。在两个治疗组中均证实了血糖控制[糖化血红蛋白、空腹和餐后2小时血糖（PPG）]的显著改善。瑞格列奈组PPG下降幅度明显大于罗格列奈组（P < 0.05）。治疗期间，两组空腹血浆胰岛素（FPI）均显著下降，二甲双胍组下降更明显（P < 0.05）。仅二甲双胍组餐后2小时血浆胰岛素（PPI）水平下降（P < 0.05）。在基线和最终访视之间，一组或两组在以下心血管风险因素方面表现出显著改善：总胆固醇、低密度脂蛋白胆固醇（LDL-C）、甘油三酯、纤溶酶原激活物抑制剂、脂蛋白（a）和同型半胱氨酸。高密度脂蛋白胆固醇（HDL-C）、载脂蛋白A-I、载脂蛋白B、纤维蛋白原无变化。体重指数（BMI）或血压。结论：瑞格列奈或二甲双胍在药物治疗初治的2型糖尿病患者中使用超过12个月与血糖控制和心血管风险特征的改善相关。后者不一定归因于药物治疗本身，但在使用这些药物开始口服降血糖药物治疗的背景下提供了保证。(C)2003爱思唯尔科学爱尔兰有限公司保留所有权利。
Objective: To compare glycaemic control and cardiovascular risk profile in patients with type 2 diabetes following 12 months' treatment with either repaglinide or metformin. Study design and methods: This was an open uncontrolled randomised study in n = 112 patients with inadequately controlled type 2 diabetes not previously treated with oral hypoglycaemic agents. Patients beginning treatment with either repaglinide or metformin entered an 8-week titration period (to optimise dosage: repaglinide, 2-4 mg/day; metformin, 1500-2500 mg/day) followed by a 12-month treatment period. Glycaemic control and cardiovascular risk factors were determined at baseline and at the end of the treatment period. Results: Mean (S.D.) final drug doses were 3 (+/-1) mg/day in the repaglinide group and 2000 (+/-500) mg/day in the metformin group. Significant improvements in glycaemic control [glycated haemoglobin, fasting and 2-h postprandial plasma glucose (PPG)] were demonstrated in both treatment groups. The decrease in PPG was significantly greater in the repaglinise group (P < 0.05). During the treatment period, fasting plasma insulin (FPI) decreased significantly in both groups, more so with metformin (P < 0.05). Two-hour postprandial plasma insulin (PPI) levels decreased only in the metformin group (P < 0.05). Significant improvements between baseline and final visit were demonstrated in one or both groups in the following cardiovascular risk factors: total cholesterol, low-density lipoprotein cholesterol (LDL-C), triglycerides, plasminogen activator inhibitor, lipoprotein(a) and homocysteine. No chances were observed in high-density lipoprotein cholesterol (HDL-C), apolipoprotein A-I, apolipoprotein B, fibrinogen. body mass index (BMI) or blood pressure. Conclusions: The use of repaglinide or metformin in drug therapy-naive patients with type 2 diabetes over a 12-month period is associated with improvements in both glycaemic control and cardiovascular risk profile. The latter cannot necessarily be attributed to the pharmacotherapy per se, but provides reassurance in the context of initiating oral hypoglycaemic drug therapy with these agents. (C) 2003 Elsevier Science Ireland Ltd. All rights reserved.