Effects of glycometide combined with acarbose or metformin on glucose and lipid metabolism as well as islet function in newly diagnosed type 2 diabetes patients
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摘要: 目的 探讨格列美脲联合阿卡波糖或二甲双胍对初诊2型糖尿病患者糖脂代谢、胰岛功能的影响。 方法 将82例初诊2型糖尿病患者按照随机数字表法分为对照组和观察组,每组41例。对照组采用格列美脲联合阿卡波糖治疗,观察组采用格列美脲联合二甲双胍治疗, 2组均持续治疗12周。观察2组治疗前后糖脂代谢指标［餐后2 h血糖(2 h PG)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)和低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、甘油三酯(TG)］、氧化应激相关标志物［活性氧类物质(ROS)、超氧化物歧化酶(SOD)、丙二醛(MDA)］和胰岛功能相关指标［胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能(HOMA-β)、胰岛素敏感指数(ISI)］水平。 结果 治疗后, 2组FBG、2 h PG、HbA1c和LDL-C、TC、TG水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05); 治疗后, 2组ROS、MDA水平低于治疗前, SOD水平高于治疗前,且观察组ROS、MDA水平低于对照组, SOD水平高于对照组,差异有统计学意义(P<0.05); 治疗后, 2组HOMA-IR水平低于治疗前, HOMA-β、ISI水平高于治疗前,且观察组HOMA-IR水平低于对照组, HOMA-β、ISI水平高于对照组,差异有统计学意义(P<0.05)。 结论 格列美脲联合二甲双胍治疗2型糖尿病的疗效优于格列美脲联合阿卡波糖,可改善患者糖脂代谢和胰岛细胞功能,减轻氧化应激损害。Abstract: Objective To investigate the effects of glycometide combined with acarbose or metformin on glucose and lipid metabolism as well as islet function in newly diagnosed type 2 diabetes patients. Methods A total of 82 patients newly diagnosed type 2 diabetes were divided into control group(n=41)and observation group(n=41)according to the random number table method. The control group was treated with glimepirea and acarbose, while the observation group(n=41)was treated with glimepirea and metformin. Both groups were treated for 12 weeks. Changes of glucose and lipid metabolism indicators［postprandial blood glucose(2h PG), fasting blood glucose(FBG), glycosylated hemoglobin(HbA1c)and low-density lipoprotein cholesterol(LDL-C), total cholesterol(TC), triglyceride(TG)］, oxidative stress related markers ［reactive oxygen species(ROS), superoxide dismutase(SOD), malondialdehyde(MDA)］ and indicators related to islet function［homeostasis model assessment of insulin resistance(HOMA-IR), β cell function(HOMA-β), insulin sensitivity index(ISI)］ levels were observed before and after treatment in both groups. Results FBG, PG and HbA1c, LDL-C, TC and TG levels after treatment were all decreased in both groups, and the above indexes in the observation group were significantly lower than those in the control group(P<0.05). After treatment, ROS and MDA levels in both groups were significantly decreased, while SOD levels were significantly increased, ROS and MDA levels in the observation group were significantly - lower than those in the control group, while SOD level was significantly higher than that in the control group(P<0.05). After treatment, the levels of HOMA-IR were decreased in both groups, while levels of HOMA-β and ISI were increased compared with treatment before(P<0.05). The levels of HOMA-IR in the observation group were lower than those in the control group, while HOMA-β and ISI levels were higher than those in the control group(P<0.05). Conclusion The efficacy of glymepiridine combined with metformin in the treatment of type 2 diabetes is superior to that of glymepiridine combined with acarbose, and can improve functions of glucose and lipid metabolism as well as islet cell, and relieve the oxidative stress injury.
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Keywords:
- type 2 diabetes /
- glycolipid metabolism /
- islet β cells /
- oxidative stress response /
- metformin
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