The Clinic Observation Of Combination Therapy Of Metformin And Other Antihyperglycemia Drugs On Patients With Type 2 Diabetes

PartⅠThe clinic observation of metformin/glipizide tablets treatment for patients with type 2 diabetesObjective: To investigate the efficacy and safety of metformin/ glipizide combination tablets in patients with type 2 diabetes, and the influence of combination tablets on serum lipid and body mass index (BMI).Methods: In this double-masked, mono-imitation, parallel-group, active-controlled study, 96 patients with type 2 diabetes were randomized divided into two groups: metformin/glipizide group(A group), metformin plus glipizide group(B group). Both groups were received treatment for 12 weeks. Maximum total daily doses were glipizide 15 mg, metformin 1500 mg, and glipizide/metformin 15/1500 mg.Results: A total of 84 patients completed the study. 43 cases were involved in A group and 41 cases were involved in B group. (1)After 12 weeks'treatment, the fasting glucose, 2-hour postprandial glucose and glycosylated hemoglobin were both significantly lower in two groups. The fasting glucose decreased by (2.25±2.56mmol/1 versus 3.15±2.68mmol/1, P=0.947), 2-hour postprandial glucose decreased by (5.26±4.60mmol/1 versus 5.79±4.87mmol/1, P=0.719), and glycosylated hemoglobin decreased by ( 2.31±1.91%versus 2.12±1.58%, P= 0.328),the changes between two groups were not different, which implict that in controlling fasting glucose, 2-hour post prandial and glycosylated hemoglobin the two methods have the similar effects. (2)The incidence of adverse events in two groups is 12.50%(6/48) versus 22.92%(11/48). The incidence of adverse reactions is 12.50%(6/48) versus 18.75%(9/48). 1 patients experienced mild hypoglycemia in B group. There is no statistic different in adverse events and adverse reactions between two groups(P=0.181 and 0.339).Conclusions: (1) Both treatments can significantly lower fasting glucose, 2-hour postprandial and glycosylated hemoglobin, and the effects are similar; two methods can decrease LDL-C and BMI as well. (2) The adverse events and adverse reactions are minor in both groups, which prompts two methods have good safety and tolerance. PartⅡThe effect of early use of insulin glargine on type 2 diabetes when metformin mono-therapy failed to control the blood sugarObejective: To appraise the efficacy and safety in early use of insulin glargine when metformin fail to control the patients' glucose of type 2 diabetes, and analyze if it can improve the function of isletβcell.Methods: In a randomized, open, parallel-group controlled study, 12 patients aged 18-80 years with type 2 diabetes, inadequate glycemic control( HbAlc＞7.5%)on metformin, were received one of two therapeutic approaches for 12 weeks: evening insulin glargine plus metformin(L-group), or glimepiride plus metformin(O-group). The Dosage of metformin was fixed, insulin glargine and glimepiride was adjusted until the fasting capillary glucose was≦ 5.6 mmol/1.Results: A total of 12 patients completed the study: 6 patients were involved in L-group, 6 in O-group. (1)Glycosylated hemoglobin were both significantly lower in two groups, the L-group has lower HbA1C (decreased by 2.80±1.40% versus 2.05±1.30%,P＜0.05)(2)There were on obvious change in function of liver and kidney, 3 patients experience mild hypoglycemia in O-group, while no patient in L-group; (3)HOMA-βvalue were both significantly higher in two groups, the L-group has higher HOMA-βvalue(66.55±32.97 versus 19.38±11.91, P＜0.05). Conclusions:(1) When metformin is failed to control the blood sugar, early use of insulin glargine have better effect in lowering HbAlc and improving the function ofβcell on patients with type 2 diabetes, compared to plus glimepiride. (2)L-group had fewer hypoglycemia events than O-group.