Efficacy And Safety Of Alogliptin Combined With Metformin And Acarbose For Middle-aged And Eldely Patient With Type 2 Diabetes

Background:Middle-aged and elderly patients are multiple population of type 2 diabetes,they are poor in physique,have many basic diseases,and have a long course of disease,are more likely to occur severe acute and chronic complications,Therefore,it is particularly important for them reducing blood sugar smoothly.Alogliptin as a highly selective dipeptidyl peptidase-IV(DPP-4)inhibitor,has been widely recognized in clinical applications.Many domestic and international studies have shown its advantages of less hypoglycemia,no weight gain,no increase in cardiovascular events,etc.But the efficacy and tolerability after combined with other antidiabetic drugs need further clinical trial data to confirmed.Objective:To observe the improvement of blood lipid and blood glucose and islet function after the treatment with alogliptin combined with metformin and acarbose in middle-aged and elderly patients with type 2 diabetes;and analyze the subject's tolerance to this combination therapy.Methods:From February 2017 to August 2017,we selected a total of 90 middle-aged and elderly patients with type 2 diabetes who treated with metformin and acarbose and come from the inpatient or outpatient of endocrine department of the affiliated hospital of Taishan medical college.The patients were randomly divided into A group and B group.Keep the original diet,exercise style,and drug use,etc.In group A,patients were treated with a small dose of alogliptin(12.5 mg once daily),and patients in group B were treated with large doses of alogliptin(12.5 mg once daily).Contrast Fasting plasma glucose(FBG),2 hours postprandial blood glucose(2hPG),glycated hemoglobin(HbA1c),fasting C-peptide(FC-P),1-hour postprandial C-peptide(1hC-P),2-hour postprandial C-peptide(2hC-P),body mass index(BMI),total cholesterol(TC),triglyceride(TG),?2-microglobulin(?2-MG),cystatin C(Cys C),alanine aminotransferase(ALT),and aspartate aminotransferase(AST)in group A and B before and after 24 weeks.To record hypoglycemia,allergic reactions,gastrointestinal reactions,and cardiovascular events that occurred during the 24 weeks.Results:After 24 weeks of treatment,the FBG,2hPG,and HbA1 c in group A and group B were lower than before(P<0.05);Compared with FBG,2hPG,and HbA1 c after treatment in group A,the decline was more significant in group B,the difference was statistically significant(P<0.05).The FC-P,1hC-P,and 2hC-P after intervention treatment in both groups were higher than before,but the change was not significant(P>0.05);There was no significant difference between the two groups(P>0.05).The body mass index(BMI)had a tendency to decrease after treatment in both groups,but P>0.05,the difference was not statistically significant.After 24 weeks,the TC,TG and HDL-C in group A were lower than before,but the difference was not statistically significant(P>0.05);TC,TG and HDL-C after treatment in group B were significantly lower than baseline(P<0.05),The difference of TC,TG and HDL-C after treatment between group A and group B was statistically significant(P<0.05).After 24 weeks,the two groups of ?2-MG and Cys C had a tendency to decrease,but the difference was not statistically significant(P>0.05);There was no significant difference of ?2-MG and Cys C between the two groups after the treatment(P>0.05).There was no significant change of ALT and AST before and after treatment in the two groups,P>0.05,the difference was not statistically significant;There was no significant difference of ALT and AST after treatment between the two groups(P>0.05).During the intervention treatment,one case of mild hypoglycemia and one case of abdominal pain occurred in group B.Conclusion:Alogliptin combined with metformin and acarbose has a good effect for type 2 diabetes in middle and old age,Blood glucose and glycated hemoglobin were both significantly lower than before,and the use of 25 mg/qd was more effective,Alogliptin combined with metformin and acarbose in the middle-aged and elderly patients with type 2 diabetes rarely occur hypoglycemia,cardiovascular events,pancreatitis,allergic reactions and other adverse events,well tolerated.