摘要
目的:应用瞬感扫描式葡萄糖监测(FGM)技术,比较达格列净或阿卡波糖联合二甲双胍对初诊2型糖尿病(T2DM)患者血糖波动的影响。方法:60例初诊T2DM患者随机分为达格列净组(达格列净联合二甲双胍治疗,30例)和阿卡波糖组(阿卡波糖联合二甲双胍治疗,30例)治疗12周。治疗前和治疗12周后佩戴FGM系统,比较两组各项代谢指标(体重、收缩压、舒张压、血尿酸、总胆固醇、三酰甘油)及血糖指标的变化,观察两组药品不良反应发生情况。结果:治疗后,两组患者的空腹血糖(FBG)、餐后血糖(2hPG)、糖化血红蛋白(HbA1c)、平均血糖水平(MBG)、平均血糖波动幅度(MAGE)、血糖波动最大幅度(LAGE)、日间血糖平均绝对差(MODD)均较前下降(P<0.05);而两组血糖达标范围内时间(TIR)均较前提高(P<0.05);但治疗后上述血糖指标两组间比较差异无统计学意义(P>0.05)。治疗后达格列净组的体重、收缩压、舒张压、三酰甘油、血尿酸等指标均较前降低(P<0.05);且收缩压、舒张压和血尿酸水平明显低于阿卡波糖组(P<0.05)。达格列净组的药品不良反应发生率低于阿卡波糖组(P<0.05)。结论:达格列净与阿卡波糖分别联合二甲双胍,降低初诊T2DM患者血糖水平、减少血糖波动方面疗效相似,而达格列净联合二甲双胍具有降低血压、血尿酸方面的优势,且不良反应率更低。
Objective:To compare the effects of metformin combined with dapagliflozin or acarbose on glycemic variability in patients with newly diagnosed type 2 diabetes mellitus(T2 DM)using transient scanning glucose monitoring(FGM).Methods:A total of 60 patients with newly diagnosed T2 DM were randomly divided into dapagliflozin group(dapagliflozin combined with metformin,30 cases)and acarbose group(acarbose combined with metformin,30 cases).The course of treatment was 12 weeks.Flash glucose monitoring(FGM)was used to evaluate the whole-day blood glucose control before treatment and 12 weeks after treatment.Metabolic indexes(body weight,systolic blood pressure,diastolic blood pressure,blood uric acid,total cholesterol,triglyceride)and dynamic blood glycemic variability indexes were compared between the two groups.The adverse drug reactions were compared between the two groups.Results:After treatment,the fasting blood glucose(FPG),2-hour post prandial plasma glucose(2 hPG),glycated hemoglobin(HbA1 c),mean blood glucose serum(MBG),mean amplitude of glucose excursions(MAGE),largest amplitude of glycemic excursions(LAGE),mean of daily differences(MODD)of the two groups were decreased than before(P<0.05).While time in range(TIR)were increased compared with those before treatment(P<0.05).However,there was no significant difference in the above blood glucose indexes between the two groups after treatment(P>0.05).The weight,systolic blood pressure(SBP),diastolic blood pressure(DBP),uric acid(UA),triglyceride(TG)of the dapagliflozin groups were decreased compared with before treatment(P<0.05),and the SBP,DBP,UA of dapagliflozin group were significantly lower than acarbose group(P<0.05).The incidence of adverse drug reactions in dapagliflozin group was lower than that in acarbose group(P<0.05).Conclusion:Dapagliflozin or acarbose combined with metformin could reduced blood glucose and improve glycemic variability in newly diagnosed T2 DM patients,the efficacy was similar.Dapagliflozin combined with metformin has more advantages in lowering the blood pressure,blood uric acid and lower adverse drug reactions.
作者
唐平
孙致连
程筱玲
王颖
万岩岩
Tang Ping;Sun Zhilian;Cheng Xiaoling;Wang Ying;Wan Yanyan(Department of General Practice,The Third Affiliated Hospital of Shenzhen University Luohu People’s Hospital of Shenzhen City;Department of Endocrinology,The Third Affiliated Hospital of Shenzhen University Luohu People’s Hospital of Shenzhen City;Department of Science and Education,The Third Affiliated Hospital of Shenzhen University Luohu People’s Hospital of Shenzhen City,Shengzhen 518001,Guangdong,China)
出处
《药物流行病学杂志》
CAS
2022年第7期435-438,共4页
Chinese Journal of Pharmacoepidemiology
基金
深圳市卫生系统科研项目(编号:SZXJ2018032)
深圳市医学重点学科建设经费资助(编号:SZXK062)。
关键词
达格列净
2型糖尿病
血糖波动
瞬感扫描式葡萄糖监测
Dapagliflozin
Type 2 diabetes
Glycemic variability
Flash glucose monitoring technology
