广州医科大学学报

目的:比较低剂量二甲双胍与常规剂量阿卡波糖对非肥胖2型糖尿病患者血糖控制的效果。方法:选取本院本科室56名非肥胖2型糖尿病患者(体重指数BMI<30),将其随机分为两组(A组n=28,B组n=28)。A组患者前3个月接受低剂量二甲双胍(500~750mg/d)单药治疗,后3个月转为接受常规剂量阿卡波糖(150~300mg/d)单药治疗。B组患者前3个月接受阿卡波糖治疗,后3个月接受二甲双胍治疗,剂量与A组相同。检测两组基线、第3个月末和第6个月末的空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)、BMI、血压和血脂水平。结果:①低剂量二甲双胍显著降低了A组(P<0.01)和B组(P<0.05)患者的FPG水平;②低剂量二甲双胍降低了A组(P<0.01)和B组(P<0.01)患者的HbA1c水平。阿卡波糖只降低了B组的HbA1c水平(P<0.05);③低剂量二甲双胍和阿卡波糖单药治疗能降低餐后2hPG,但是不能达到治疗目标值。结论:低剂量二甲双胍与常规剂量阿卡波糖相比,前者对非肥胖2型糖尿病患者的血糖控制效果更佳。

Objective:To evaluate the glycemic control with low dose metformin vs acarbose in type 2 diabetes. Methods:56 non-obese type 2 diabetic patients ( BMI <30) were randomly divided into two groups. Group A (n=28) was treated with low dose metformin (500-750 mg/d) for 3 months, and switched to acarbose (150-300 mg/d) for another 3 months. Group B (n=28) was treated with acarbose first, and then switched to low dose metformin. The fasting plasma glucose (FPG), 2 h-postprandial blood glucose (2 h PG), HbA1c, blood Lipid, blood pressure (Bp) and BMI were measured at baseline, the end of the 3rd month and the end therapeutic session. Results:①Low dose metformin significantly decreased FPG levels in both groups A (P<0.01)and B (P<0.05);② Low dose metformin significantly decreased HbA1c levels in both groups A (P<0.01) and B (P<0.01),whereas acarbose decreased HbA1c levels only in group B (P<0.05);③ Both low dose metformin and acarbose decreased 2 h PG levels, but did not reach the goal level. Conclusion:Low dose metformin therapy appears better than routine dosage acarbose therapy in improving glycemic control of nonobese diabetics.