Efficacy And Security Of Sitagliptin Combined With Metformin In Type2Diabetes

Objective To investigate the clinical efficacy and safety of metformin combined withsitagliptin in type2diabetes patientsMethods：Choose60cases of only oral stable doses of metformin (≥1500mg/day) at leastfor10weeks and blood glucose control is still not up to standard in patients with type2diabetes.60patients with type2diabetes were randomly assigned to two groups,theexperimental group added in sitagliptin (100mg/pill),the control group added inrepaglinide(0.5mg/pill)15-30minutes before meals.All patients with diabetic standardcaloric diet and exercise as a basis for the treatment.After48weeks,Self-controlled methodand two groups controlled method observe the changes of fasting plasma glucose(FBG),2hours postprandial plasma glucose(2hPG),glycosylated hemoglobinA1c(HbAlc),bloodpressure(BP),body mass index(BMI),homeostasis model assessment of insulin resistanceindex(HOMA-IR),Homeostasis model assessment of β-cell Function Index(HOMA-β),Fas-ting C-peptide(FCP),2hours postprandial C-peptide(2h-CP),blood fat,Intima MediaThickness(IMT),Endothelium dependent diastolic function(FMD) and other indicators.Atthe same time observation blood sugar(fasting blood glucose,blood sugar of2hours afterbreakfast,blood sugar of before lunch, blood sugar of2hours after lunch,blood sugar ofbefore dinner,blood sugar of2hours after dinner) changes of experimental group patients atdifferent time points during the day oral sitagliptin.Results1.General compare of before and after treatment the experimental group and control group and between two groupsCompared with before treatment, the control group BMI,SBP,DBP no obvious changeand not statistically significant;experimental group BMI,SBP were significantlydecreased,the difference was statistically significant (P<0.05),DBP was decreased,thedifference was not statistically significance;After treatment the experimental group thancontrol group BMI,SBP significantly decreased,the difference was statisticallysignificant(P<0.05),DBP was decreased,the difference was not statistically significance.2.Blood glucose and HbAlc compare of before and after treatment the experimental groupand control group and between two groupsAfter treatment the experimental group and control group FBG,2hPG, HbAlc weresignificantly decreased, before and after treatment the two groups have differences werestatistically significant (P<0.05orP<0.01).but,the experimental group and control groupafter treatment,the difference was not statistically significant.3.FCP,2hCP,HOMA-β and HOMA-IR compare of before and after treatment theexperimental group and control group and between two groupsCompared with before treatment, the control group FCP,2hCP,HOMA-β were elevated，HOMA-IR was deceased,the difference was not statistically significance.The experimentalgroup FCP,2hCP and HOMA-β were significant elevated,HOMA-IR significantdeceased,the difference were statistically significant(P<0.05).After treatment theexperimental group than control group FCP,2hCP and HOMA-β were significant elevated,HOMA-IR was significant deceased,the difference were statistically significant(P<0.05).4.Vascular function compare of before and after treatment the experimental group andcontrol group and between two groupsCompared with before treatment, the control group IMT,FMD no difference,thedifference was not statistically significance.The experimental group IMT was significantdeceased,FMD was significant elevated,the difference were statistically significant(P<0.05).After treatment the experimental group than control group IMTwas significantdeceased,FMD was significant elevated,the difference were statistically significant(P<0.05).5.Blood fat compare of before and after treatment the experimental group and control group and between two groupsThis study patients without oral lipid-lowering drugs during treatment.the control groupTG,TC,LDL-C,HDL-C,HDL-C were different,the difference was not statisticallysignificance.The experimental group HDL-C was significant elevated,TG,TC,LDL-Cwere significant deceased,the difference were statistically significant(P<0.05).Aftertreatment the experimental group than control group HDL-C was significant elevated,TG,TC,LDL-C were significant deceased,the difference were statistically significant(P<0.05).6.Blood sugar changes of in experimental group patients at different time points during theday oral sitagliptin.Experimental group patients at different time points oral sitagliptin,not affected bytaking time, at any time of day to take the sitagliptin,statins can reduce blood sugar steady.Conclusions1. Sitagliptin and metformin relative to repaglinide tablets and metformin1.1By elevated FCP、2hCP and HOMA-β,deceased HOMA-IR,can improve the function ofislet,improve insulin resistance.2.2By lose weight,deceased SBP,deceased blood fat,deceased IMT,elevated FDMpreventing cardiocerebrovascular events occur.2. Sitagliptin and metformin2.1Decease FBG,2hPG,HbAlc,stationary lower blood sugar2.2No hypoglycaemia, no liver, kidney damage，no acute pancreatitis and other occur.