[1]金晖,鲍洁,赵镇,等.米格列奈与瑞格列奈对新诊断2型糖尿病的临床疗效研究[J].第三军医大学学报,2013,35(03):260-263.
 Jin Hui,Bao Jie,Zhao Zhen,et al.Clinical efficacy of mitiglinide and repaglinide in treatment of patients with newly diagnosed type 2 diabetes mellitus[J].J Third Mil Med Univ,2013,35(03):260-263.
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米格列奈与瑞格列奈对新诊断2型糖尿病的临床疗效研究(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
35卷
期数:
2013年第03期
页码:
260-263
栏目:
论著
出版日期:
2013-02-15

文章信息/Info

Title:
Clinical efficacy of mitiglinide and repaglinide in treatment of patients with newly diagnosed type 2 diabetes mellitus
作者:
金晖鲍洁赵镇孙子林
东南大学附属中大医院内分泌科
Author(s):
Jin Hui Bao Jie Zhao Zhen Sun Zilin
Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, Jiangsu Province, 210009, China
关键词:
2型糖尿病米格列奈瑞格列奈动态血糖监测系统
Keywords:
T2DM mitiglinide repaglinide continuous glucose monitoring system
分类号:
R587.1; R969.4; R977.15
文献标志码:
A
摘要:
目的      比较米格列奈与瑞格列奈对新诊断2型糖尿病患者(T2DM)在糖代谢、心血管危险因子、氧化应激方面的影响,了解米格列奈药物的短期和中期疗效。      方法        2010年4月至2011年1月在我院新诊断90例T2DM患者按随机数字表法分为A、B组(n=45),A组给予瑞格列奈+二甲双胍,B组给予米格列奈+二甲双胍,应用动态血糖监测系统(CGMS)记录3 d内的动态血糖水平和波动趋势,之后12周定期随访相应指标。      结果      2组治疗后3 d,空腹血糖、3餐后平均血糖(MBG)及日内血糖平均水平均较治疗前降低,B组餐后1 h及2 h MBG降幅大于A组(P<0.05),平均血糖波动幅度(MAGE)小于A组(P<0.05);12周后,2组空腹及餐后1、2 h血糖均明显降低,B组降幅大于A组;空腹及餐后1、2 h 胰岛素(FINS、1 h INS、2 h INS)不同程度升高,B组1 h INS、2 h INS增幅大于A组;B组降低HbA1c幅度大于A组;2组均能降低胰岛素抵抗指数(HOMA-IR)、升高胰岛素敏感指数(ISI),B组优于A组(P<0.05);B组低血糖发生人次低于A组。2组均能不同程度降低总胆固醇(TC)、甘油三酯(TG)、纤维蛋白原(FG)水平,升高高密度脂蛋白胆固醇(HDL-c)水平,2组对纤溶酶原激活物抑制因子-1(PAI-1)下降作用均不明显(P>0.05);B组降低超氧化物歧化酶(SOD)、升高丙二醛(MDA)优于A组(P<0.05)。      结论        米格列奈与瑞格列奈均能在短期内降低新诊断T2DM患者的血糖,但米格列奈组平均血糖波动幅度小;中期治疗后,与瑞格列奈比较,米格列奈能更好地提高糖化血红蛋白达标率,降低低血糖发生率,改善氧化应激因子。
Abstract:
Objective        To compare the effect of mitiglinide and repaglinide on glycometabolism, cardiovascular risk factors and oxidative stress in patients with newly diagnosed type 2 diabetes mellitus (T2DM).       Methods       Ninety newly diagnosed T2DM patients were randomly assigned to group A and group B. The patients of group A received repaglinide plus metformin treatment, while those of group B were given mitiglinide plus metformin treatment. Continuous glucose monitoring system (CGMS) was used to record the dynamic changes and fluctuation of blood glucose in all patients during the first 3 days. All the patients were followed up to examine the corresponding indices after 12 weeks.       Results       After treatment for 3 days, the fasting blood glucose (FBG), mean blood glucose (MBG) at 30 min, and 1, 2 and 3 h after meals, and 24 h MBG decreased in both groups. The decrease of 1 h MBG and 2 h MBG was more significant in group B than in group A (P<0.05), while the mean amplitude of glycemic excursion (MAGE) was significantly lower in group B than in group A (P<0.05). Twelve weeks later, FBG and postprandial blood glucose (1 h PBG and 2 h PBG) significantly decreased in both groups (P<0.05), and the decrease in group B was more significant than that in group A (P<0.05). Fasting insulin (FINS) and postprandial insulin (1 h INS and 2 h INS) increased in both groups, and the increase of 1 h INS and 2 h INS was more significant in group B than in group A (P<0.05). Glycosylated hemoglobin-A1c (HbA1c) in both groups decreased (P<0.05), and the decrease was more significant in group B than in group A.  Both groups could significantly decrease the level of HOMA insulin resistance (HOMA-IR) and increase the level of insulin sensitive index (ISI) (P<0.05), and the effect was more significant in group B than in group A (P<0.05). The proportion of hypoglycemia in group B was lower than that in group A. Both groups could partly decrease the levels of total cholesterol (TC), triglycerides (TG) and fibrinogen (FG), and increase the level of high-density lipoprotein cholesterol (HDL-c). However, they had no significant effect on plasminogen activator inhibitor-1 (PAI-1) (P>0.05). Both groups could decrease the level of superoxide dismutase (SOD) and increase the level of malondialdehyde (MDA), and the effect was more significant in group B than in group A (P<0.05).       Conclusion       For newly diagnosed T2DM, both mitiglinide and repaglinide can decrease FBG and PBG significantly in a short term, but mitiglinide can keep MAGE more steadily. After a long period of therapy, mitiglinide can significantly decrease the levels of cardiovascular risk factors and suppress antioxidative stress with lower incidence of hypoglycemia as compared with repaglinide.

参考文献/References:

金晖, 鲍洁, 赵镇, 等. 米格列奈与瑞格列奈对新诊断2型糖尿病的临床疗效研究[J].第三军医大学学报,2013,35(3):260-263.

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更新日期/Last Update: 2013-01-29