A Comparative Study of the Effects of a Dipeptidyl Peptidase-IV Inhibitor and Sulfonylurea on Glucose Variability in Patients with Type 2 Diabetes with Inadequate Glycemic Control on Metformin
A Comparative Study of the Effects of a Dipeptidyl Peptidase-IV Inhibitor and Sulfonylurea on Glucose Variability in Patients with Type 2 Diabetes with Inadequate Glycemic Control on Metformin
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DOI：
10.1089/dia.2013.0038
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发表时间：
2013-10-01
影响因子：
5.4
通讯作者：
Yoon, Kun-Ho
中科院分区：
文献类型：
--
作者：
Kim, Hun-Sung;Shin, Jeong-Ah;Yoon, Kun-Ho
背景资料：本研究的目的是比较西格列汀对血糖变化和24小时血糖变异性与磺脲类药物格列美脲的影响。我们招募了33名接受二甲双胍治疗至少2个月的患者。每名接受二甲双胍处方的受试者被随机分配到西格列汀（100 mg）或格列美脲（2 mg）组。在基线和4周随访时，使用连续葡萄糖监测（CGM）连续3天监测两组的血糖变化。使用CGM获得血糖变化和葡萄糖变异性，并对所有受试者的这些数据进行平均。基线和4周随访之间的糖化血红蛋白（HbA 1c）比较显示，西格列汀组的HbA 1c显著降低（7.0 +/- 0.5%至6.6 +/-0.4%，P < 0.001）和格列美脲组（7.3 +/- 0.4%至6.9 +/-0.4%，P < 0.001）。4周后，西格列汀组和格列美脲组的HbA 1c水平相似，两组之间无显著差异。西格列汀组血糖波动的平均幅度（法师）显著降低（4.9 +/- 1.0至3.7 +/- 0.9 mmol/L，P < 0.001），但格列美脲组无显著差异（5.7 +/- 1.5至5.0 +/- 1.4 mmol/L，P = 0.175）。结论：西格列汀与二甲双胍联合治疗对糖尿病患者的血糖控制效果更好，不仅对空腹血糖、餐后血糖、糖化血红蛋白3项指标有明显改善，而且对法师也有明显改善。
Background: This study aimed to compare the effects of sitagliptin on glycemic change and 24-h blood glucose variability with those of the sulfonylurea glimepiride.Subjects and Methods: A 4-week randomized double blind-labeled prospective design was used. We recruited 33 patients who had been treated with metformin for at least 2 months. Each participant prescribed with metformin was randomly assigned to either the sitagliptin (100 mg) or the glimepiride (2 mg) group. Continuous glucose monitoring (CGM) was used to monitor glycemic changes for 3 successive days in both groups at baseline and at the 4-week follow-up. Glycemic changes and glucose variability were obtained using CGM, and these data were averaged over all subjects.Results: The comparison of glycated hemoglobin (HbA1c) between baseline and the 4-week follow-up showed that HbA1c was significantly reduced in the sitagliptin group (7.0 +/- 0.5% to 6.6 +/- 0.4%, P < 0.001) and the glimepiride group (7.3 +/- 0.4% to 6.9 +/- 0.4%, P < 0.001). The sitagliptin and glimepiride groups had similar HbA1c levels after 4 weeks, and there were no significant differences between the two groups. The mean amplitude of glycemic excursions (MAGE) decreased significantly in the sitagliptin group (4.9 +/- 1.0 to 3.7 +/- 0.9 mmol/L, P < 0.001), but no significant difference was observed in the glimepiride group (5.7 +/- 1.5 to 5.0 +/- 1.4 mmol/L, P = 0.175). The SD and oxidative stress markers did not differ significantly between the two groups.Conclusions: When sitagliptin was combined with metformin, the patients showed much more efficient blood glucose controlling effects, not only the three indexes of fasting blood glucose, postprandial blood glucose, and glycated hemoglobin, but also MAGE.