2型糖尿病口服降糖药的应用备案教材.ppt

2型糖尿病口服降糖药的应用 * 研究结果显示诺瑞格列奈单药已经能够能好的控制血糖，联合用药组效果进一步加强。 * * * 按ADA/EASD标准(HbA1c7.0%),两组患者达标率为70%以上 以上从理论基础看瑞格列奈联合二甲双胍的优势，我们再看看联合二甲双胍，瑞格列奈与长效SU类格列美脲的头对头的研究 Bratisl Lek Listy. 2009;110(6):335-9. Evaluation of the repaglinide efficiency in comparison to the glimepiride in the type 2 diabetes patients poorly regulated by the metmorfine administration. Dimic D, Velojic Golubovic M, Antic S, Radenkovic S. Source Clinical Center Nis, Clinic ofEndocrinology, Diabetes and Metabolic Disorders, Nis, Serbia. drdragand@bankerinter.net Abstract OBJECTIVES: An impaired early phase of insulin secretion in the type 2 diabetes mellitus (DM) is very important for the postprandial hyperglycemia. The aim of the study was to compare the efficacy of metformin/repaglinid and metformin/glimepirid regimes in type 2 diabetics uncontrolled with metformin monotherapy. METHODS: Totally, 60 type 2 diabetics with haemoglobin A1c or = 7.5% and 2000 mg of metformin monotherapy for at least three months were divided in the following groups: A-30 patients with metformin+repaglinid (2 mg for each meal) and B metformin+glimepirid (3 mg in the morning). Assessment of the regimes efficacy comprised of haemoglobin A1c, fasting blood glucose (FBG) and postprandial blood glucose (PBG). Assessment of the safety was performed on the basis of recorded hypoglycemia (4.0 mmol/l). RESULTS: In both groups, FBG was significantly lower at the end of the study. In the group A it decreased from 9.03 +/- 1.00 to 7.32 +/- 0.65 (p 0.001), in the group B from 8.94 +/- 1.01 to 7.23 +/- 0.70 (p 0.001). There was no statistical difference between the groups. PBG was significantly lower after 12 weeks in both groups. CONCLUSION: Metformin/repaglinid is an efficient and safe therapeutic regime in the treatment of the type 2 DM that ensure a better control of PBG levels (Tab. 4, Ref. 18). PMID:[PubMed - indexed for MEDLINE] * 瑞格列奈组的餐后血糖及糖化血红蛋白下降更显著 两者低血糖发生次数相近 * * * 基于临床上瑞格列奈的理想肾脏安全性，2007年美国肾脏协会指南明确指出，在CKD