南方医科大学学报 ›› 2014, Vol. 34 ›› Issue (10): 1515-.

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维格列汀联合门冬胰岛素治疗老年2 型糖尿病患者的疗效及安全性

许翎,林凯,邓海鸥,黎映兰,智喜梅,张伟杰,吴文   

  • 出版日期:2014-10-20 发布日期:2014-10-20

Therapeutic effect of vildagliptin and insulin aspart injection in elderly patients with
type 2 diabetes

  • Online:2014-10-20 Published:2014-10-20

摘要: 目的观察维格列汀联合门冬胰岛素治疗老年2型糖尿病患者的疗效及安全性。方法对66例使用门冬胰岛素血糖控制不
佳的老年2型糖尿病患者随机分两组:观察组36例,加用维格列汀50 mg,2次/d口服;对照组30例,加用阿卡波糖50 mg,3次/d
餐中嚼碎服。使用12 周后观察两组空腹血糖(FBG)、餐后2 h 血糖(2 hPG)、糖化血红蛋白(HbA1c)、空腹C肽、餐后2 hC肽
(2 hC 肽)、体质量指数(BMI)、肾小球滤过率(GFR)的变化。结果观察组治疗后FBG、2 hPG、HbA1c 均较治疗前下降(P<
0.05),空腹及2 hC肽较治疗前升高(P<0.05),BMI、GFR与治疗前无明显变化(P>0.05);对照组治疗后2 hPG、HbA1c较治疗前
下降(P<0.05),FBG、空腹C肽、2 hC肽、BMI、GFR与治疗前比无明显变化(P>0.05);观察组与对照组相比,FBG显著降低(P<
0.05),空腹C肽、2 hC肽显著升高(P<0.05),2 hPG、HbA1c、BMI、GFR无明显差异(P>0.05)。低血糖:两组均无一次发生。结
论维格列汀联合门冬胰岛素与阿卡波糖联合门冬胰岛素对降低2 hPG、HbA1c疗效相当,且无体重增加及GFR下降,无低血糖
发生。而且维格列汀联合胰岛素较对照组在降低FBG、改善胰岛β细胞功能上作用更明显。

Abstract: Objective To observe the therapeutic effect and safety of vildagliptin combined with insulin aspart injection in
elderly patients with type 2 diabetes. Methods Sixty-six elderly patients with type 2 diabetes who had poor blood glucose
control with insulin aspart injection were divided into two groups to have additional Vildagliptin (50mg, twice daily, n=36,
observation group) or Acarbose (50 mg, three times a day, n=30, control group). Blood glucose (including FBG and 2hPG),
HbA1C, fasting c-peptide, postprandial c-peptide, BMI and GFR were observed after 12 weeks. Results In the observation
group, FBG, 2hPG and HbA1C decreased significantly (P<0.05), fasting and postprandial c-peptide increased (P<0.05), and
BMI and GFR showed no obvious changes (P>0.05). In the control group, 2hPG and HbA1C were significant lowered (P<0.05)
but FBG, fasting and postprandial c-peptide, BMI or GFR showed no changes (P>0.05). Compared with those in the control
group, FBG in the observation group showed a significant reduction (P<0.05), but no significant differences were found in
2hPG, HbA1C, BMI or GFR (P>0.05). No hypoglycemia occurred in the two groups during the treatment. Conclusion
Vildagliptin with insulin aapart injection has equivalent effect with Acarbose combined with insulin aspart injection in
decreasing 2hPG and HbA1C without increasing the body weight or the risk to hypoglycemia or causing lowered GFR.
Vildagliptin has better effect in decreasing FBG and improving the function of the islet cells.