| Objective: To compare the effect,safety and body fat of dapagliflozin,acarbose and metformin in elderly patients with type 2diabetes.Methods:Recruited elderly patients with type 2 diabetes from the First People's Hospital of Xiangtan City from November 2018 to September 2019.A total of 72 cases,of which 60 patients were successfully screened and randomized,finally 56 patients completed a24-week treatment,all patients after 4 weeks of diet exercise intervention,starting from the initial dose,4 weeks after reaching maintenance Dose,complete the general conditions [height,weight,body mass index(BMI),waist-to-hip ratio(WHR),blood pressure],glucose metabolism indicators[fasting blood glucose(FPG),2 hour postprandial blood glucose(2h PPG)at baseline and week 24,Glycosylated hemoglobin(Hb A1c)],biochemical indicators(hemoglobin,liver and kidney function,urine microalbumin / urinary creatinine),body composition [total muscle mass,total skeletal muscle,total fat mass,fat percentage,visceral fat area,bone Density(BMD)],record the side effects and check the dose.Use IBM SPSS 26.0 software for data statistical analysis.Result:1.Baseline comparison: The baseline characteristics of the three groups are similar.2.Changes in glucose metabolism: After 24 weeks of treatment in the three groups,Hb A1 c,FPG,and PPG in the three groups were significantly lower than the baseline(p <0.01).The three groups of Hb A1 c and 2h PPG showed similar reductions(p> 0.05).The FPG decrease value of the metformin group was significantly greater than that of the acarbose group(Acarbose vs metformin: 1.50 ± 1.26vs2.19 ±0.75 mmol / L p = 0.044);the FPG decrease of the metformin group was similar to that of dapagliflozin group(p> 0.05);FAG levels in the dapagliflozin group and the acarbose group were comparable(p> 0.05).3.Changes in lipid metabolism indexes: After 24 weeks of treatment in the three groups,the Total cholesterol(TC)in the acarbose group significantly decreased from baseline(p <0.01);the Triglyceride(TG)in the dapagliflozin group significantly decreased from baseline(p <0.01),High density lipoprotein cholesterol(HDL-C)was significantly higher than baseline;TC and TG in the metformin group were significantly lower than baseline(p <0.01).4.Changes in urine microprotein / creatinine ratio(UACR): After 24 weeks of treatment in the three groups,the UACR of the dagligliflozin group decreased significantly from baseline(p <0.05).5.Changes in body weight and BMI: After 24 weeks of treatment in the three groups,the weight and BMI of the three groups were significantly lower than the baseline(p <0.01).Sugar group and metformin group(p <0.05).6.Changes in waist-to-hip ratio: After 24 weeks of treatment in the three groups,the waist-to-hip ratio in the dagliflozin group decreased significantly from baseline(p <0.05);Metformin group(p <0.01);7.Changes in blood pressure: After 24 weeks of treatment in the three groups,the systolic blood pressure of the dapagliflozin group and the metformin group decreased significantly from baseline(p <0.01);Group(p <0.01).The diastolic blood pressure in the acarbose group and the dagligliflozin group was significantly lower than the baseline(p<0.01);the diastolic blood pressure of the three groups was similar(p>0.05).8.Changes in body composition: After 24 weeks of treatment in the three groups,there was no significant difference in total body BMD(vertebral body and femoral neck),total muscle and total skeletal muscle from the baseline(p> 0.05).The area of body fat and visceral fat in the metformin group and the daglitazone group was significantly lower than the baseline(p <0.01).p> 0.05).9.Adverse reactionsDuring monotherapy,no serious hypoglycemic adverse events anddeaths were found in the three groups.There were 1 case(5%)of urinary tract infections in the daglitazone group;2 cases(10%)of the acarbose group Gastrointestinal reactions showed bloating and increased exhaust;a total of 1 case(5%)in the metformin group had gastrointestinal reactions,showing abdominal pain and bloating.Conclusion:1.In this study,for the elderly type 2 diabetes patients,the three groups of drugs can effectively improve the sugar metabolism indicators,and the three groups of drugs have the same effect on reducing Hb A1 c.2.In this study,the three groups of drugs can significantly reduce body weight and BMI,of which dapagliflozin is the most obvious weight loss,mainly reducing visceral fat.3.In this study,the three groups of drugs are relatively safe to use in elderly patients with type 2 diabetes,but for dapagliflozin,more time and more research are needed to verify the safety in the elderly. |
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