摘要
T2DM发病的主要病理生理机制是IR和胰岛分泌功能障碍,其治疗方案应针对已知的病因弥补其病理生理缺陷。二甲双胍是指南推荐的一线用药,当单独使用二甲双胍不能有效控制血糖时,常需要不同作用机制的口服药联合应用。二甲双胍和促泌剂联合应用是临床常用的联合用药方案,二甲双胍可提高胰岛素敏感性,胰岛素促泌剂,尤其是早相胰岛素促泌剂可针对早相胰岛素分泌受损的特点,促进早相胰岛素分泌,有效降低餐后血糖。二者机制互补,联合使用可带来更多益处。临床随机对照研究的结果也证实联合使用后空腹及餐后血糖均显著改善,HbA1c达标率提高,且安全性、耐受性良好。
Insulin resistance and secretory dysfunction of β cell are the main pathophysiological defects in patients with type 2 diabetes that should be focused on when determining the treatment regimen. Metformin is recommended as first-line treatment in most global guidelines. When metformin failed to control blood glucose, the combination therapy of medications with diverse mechanisms of action should be initiated. The combination of metformin and insulin secretagogues is widely used in clinical practice. Metformin improves insulin sensitivity, while early phase insulin secretagogues promote early phase insulin secretion and effectively reduce postprandial blood glucose. Given the complementary mechanisms, the combination therapy of metformin and early phase insulin secretagogues can benefit patients with type 2 diabetes. Randomized controlled clinical trials showed that the combination therapy can improve fasting and postprandial blood glucose, with more patients arriving target HbA1 c level. The combination therapy is safe and well tolerated.
出处
《中国糖尿病杂志》
CAS
CSCD
北大核心
2012年第11期877-879,共3页
Chinese Journal of Diabetes
关键词
二甲双胍
早相胰岛素促泌剂
联合用药
瑞格列奈
糖尿病
2型
Metformin
Early phase insulin secretagogues
Combination therapy
Repaglinide
Diabetes mellitus , type 2
