| Purpose:The number of diabetics is increasing tremendously in the recent yearswith the improvement of living standards. Diabetes mellitus, with thesymptoms of high blood glucose and vascular and macro vascularcomplications, has seriously threaten the health and life quality of diabetics,and caused great harm to our family, society and country. As medical workers,we are aiming to keep the blood glucose within a standard level, as well as toavoid the incidence rate of hypoglycemia by lowering the blood glucosesmoothly. Therefore, we could avoid the various of adverse reactions. Type2diabetes mellitus is caused by combined effects of multiple factors. It’s widelyaccepted that insulin resistance and β cell dysfunction are the fundamentalreasons for Type2diabetes mellitus. To effectively improve the insulinresistance and β cell dysfunction are the key matters for blood glucose control.The common clinical treatments for Type2Diabetics are application of insulinand oral hypoglycemic drugs. DPP-4, as a new kind of hypoglycemic drugs, arewidely used in clinical treatment in recent years. DPP-4is a kind of serineproteinase inhibitor, which adjust the blood glucose by degrading incretion.Different from traditional hypoglycemic drugs, DPP-4improves the ability of βcell of producing the insulin. When the blood glucose increased, the secretorycells of stomach and intestine would secreted two kinds of incretions: GLP-1and GIP, both of which could lower the blood glucose and avoid thehypoglycemia to some degree by promoting the secretion of insulin. It wasrarely reported that sitaglipitin, sitaglipitin Phosphate and Vildagliptin hadserious adverse reaction since the DPP-4are applied in clinic. DDP-4may have adverse effects on langerhans’ islet because it contains elements that stimulatethe stomach and intestine. Therefore, patients with functional insufficiency inpancreas shall use it cautiously. To investigate the effects and safety ofsitagliptin in clinical treatment, the author observed and researched the Type2Diabetics who take the sitagliptin for twelve weeks.Method：In accordance with WHO1999diagnosis and classification of diabetesmellitus, the author selected60type2diabetics. Case inclusion criteria:21-70years of age; no gender limitation; no diseases duration limitation; fastingfinger blood glucose7.0-13.0mmol/L;19kg/m~2≤BMI≤35kg/m~2; useing thetreatment of diet control and exercise; not including patients with seriousdiseases of stress, liver, kidney, stomach, intestine, heart, blood, breathing,nerver and addictive drug abuse; not inlcuding patients with other seriousendocrinopathy, such as hyperthyreosis, hypothyroidism and hypercortisolism.Diabetics are divided into two groups: diabetics in Group One are givenSitagliptin for100mg once a day before the breakfast; diabetics in Group Twoare given Acarbose50mg3times a day with meals. The treatment period istwelve weeks. Applied SPSS18.0statistical software for statistical analysis,used the（x±s）to express the data, check the average number in two groups byt test, anylysed average numbers among different groups through variance.Results:After the treatment of Sitagliptin, fasting plasma glucose,2-hourpostprandial glucose and HbA1c are reduced significantly compared with thosebefore, and the differences have statistical significance (P <0.05).Nohypoglycemia and other adverse reactions are abserved during the treatmentperiond.Conclusion:Sitagliptin can effectively reduce the fasting plasma glucose and postprandial blood glucose, as well as control the HbA1c. However, it has noobvious effects on adjusting the blood lipid of Type2diabetics. None of the30patients has hypoglycemia or other adverse reactions. The long-termobservations and studies on a large number of clinical samples are still need forthe safely of Sitaglipin in medical treatment. |
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