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目的观察沙格列汀与阿卡波糖治疗血糖控制不佳伴超重的2型糖尿病患者的疗效、安全性。方法选取合并超重的初诊2型糖尿病患者80例,所有患者试验前在生活方式干预基础上给予二甲双胍联合胰岛素治疗,但血糖控制不佳(Hb A1c>7.5%)。所有患者随机分为沙格列汀组和阿卡波糖组各40例,均治疗12周,观察并记录2组患者治疗前后空腹血糖(FBG)、餐后2h血糖(PG2h)、糖化血红蛋白(Hb A1c)、胰岛素用量、低血糖发生率、不良反应发生率,肝肾功能变化情况。结果 2组治疗后FBG、2h PG、Hb A1c和胰岛素使用量均较治疗前下降,沙格列汀组下降程度高于阿卡波糖组,差异有统计学意义(P<0.05)。2组肝肾功能检查指标比较差异均无统计学意义(P>0.05)。结论沙格列汀对超重的2型糖尿病患者安全有效,可降低糖化血红蛋白水平,减少胰岛素用量。
Objective To observe the efficacy and safety of saxagliptin and acarbose in the treatment of type 2 diabetes with poor control of blood glucose and overweight. Methods Eighty newly diagnosed type 2 diabetic patients with overweight were selected. All patients were treated with metformin combined with insulin on the basis of lifestyle intervention before the test, but their blood glucose was poorly controlled (Hb A1c> 7.5%). All patients were randomly divided into Saxagliptin group and Acarbose group, 40 cases each for 12 weeks. The levels of fasting blood glucose (FBG), postprandial blood glucose (2h), glycosylated hemoglobin Hb A1c), insulin dosage, incidence of hypoglycemia, incidence of adverse reactions, changes in liver and kidney function. Results The FBG, 2h PG, Hb A1c and insulin dosage in the two groups were significantly lower than those before the treatment. The descent in the saxagliptin group was higher than that in the acarbose group (P <0.05). There was no significant difference between the two groups in liver and kidney function tests (P> 0.05). Conclusions Saxagliptin is safe and effective in overweight patients with type 2 diabetes mellitus, reducing HbA1c and decreasing insulin dosage.