To Investigate The Comparison Of The Efficacy Of Acarbose And Metformin In Patients With Newly Diagnosed Type 2 Diabetes At Different Baseline Levels Of TG/HDL-C

Background:Type 2 diabetes mellitus(T2DM)is a common chronic disease in clinical medicine.The morbidity and fatality rate are increasing year by year.And it poses a serious threat to people's health.Early diagnosis and intensive hypoglycemia are of great significance to improve the prognosis of patients.Insulin resistance is one of the obvious characteristics of type 2 diabetes mellitus.At present,the gold standard technical barrier of glucose clamp detection is high,which makes it inconvenient to detect insulin resistance in clinical practice.Clinical studies have found that there are many indicators that can indirectly detect insulin resistance,but most of them require the detection of insulin level.Compared with them,TG/HDL-C ratio is easier to obtain.In previous MARCH studies,acarbose and metformin have been shown to have similar hypoglycemic effects.At present,no studies have been conducted on whether TG/HDL-C affects the therapeutic effect of acarbose and metformin.Objective:To compare the efficacy of acarbose and metformin in newly diagnosed type 2 diabetes patients at different baseline levels of TG/HDL-C.Methods:A subgroup analysis was performed on 640 subjects who completed 48 weeks of follow-up in the MARCH study.Patients were divided into low TG/HDL-C group and high TG/HDL-C group with the median TG/HDL-C value of 1.55 as the cut-off value according to their baseline TG/HDL-C levels,including 317 patients in the low TG/HDL-C group and 323 patients in the high TG/HDL-C group.The baseline difference between the two groups and the difference between the two groups after hypoglycemic treatment were compared.Then we the compared differences between the two groups after treatment with acarbose and metformin.The taget of HbAlc was<7%.SPSS24.0 software was used for data statistics,and the significance level P value was set at 0.05.Results:At the end of 48 weeks of treatment,there was no statistical difference in the HbAlc compliance rate among the TG/HDL-C level groups regardless of acarbose or metformin.At 48 weeks,acarbose was superior to metformin in reducing 2hPPG in the low TG/HDL-C group(P<0.05).Under the high TG/HDL-C level grouping,the difference of TG change between acarbose group and metformin group was statistically significant(P<0.05),indicating that acarbose had a better effect on reducing TG than metformin.Conclusions:1.Regardless of baseline TG/HDL-C ratio,acarbose and metformin have no significant difference in reaching the target of HbAlc.2.The difference of HbAlc reduction in patients with high TG/HDL-C level was significantly better than that in the group with low TG/HDL-C level.3.The effect of acarbose on reducing 2hPPG in patients with low TG/HDL-C level was significantly better than that of metformin.