亚莫利控制血糖.ppt

亚莫利?双管齐下 足量达标 亚莫利?有效降低空腹血糖和餐后血糖 一项为期8周、非干预性研究 共22045例患者接受格列美脲治疗，29.3%患者初始治疗，70.7%患者转换至格列美脲治疗 ，对研究期间的剂量、HbA1c、不良事件及失访情况进行分析 结果显示，格列美脲治疗的HbA1c自基线下降1.6%，低血糖发生率仅为0.28% 亚莫利? 4mg/天的治疗依从性更高 格列美脲1mg、4mg和8mg组与安慰剂组均未出现实验室证明的低血糖（FPG3.3mmol/L） * * AIM: To determine the efficacy of, and compliance with, glimepiride or acarbose in patients with Type 2 diabetes. METHODS: Two hundred and nineteen patients with Type 2 diabetes uncontrolled by diet alone were randomized to receive either glimepiride (1, 2, 3, 4 or 6 mg once daily, n = 111) or acarbose (50, 100, 150 or 200 mg 3 times daily, n = 108). Both drugs were titrated in a 6-week dose-finding phase to achieve a fasting blood glucose (FBG) concentration or = 7.8 mmol/ (140 mg/dl). Patients achieving this target entered a 20-week treatment period. Efficacy was assessed by responder rate, number of patients achieving a FBG of or = 7.8 mmol/l, HbA1c, blood glucose concentrations in response to a standard breakfast, body weight and compliance. RESULTS: Glimepiride was associated with a significantly greater responder rate than acarbose (61 vs 34%, p 0.001), significantly greater decreases in HbA1c (2.5 +/- 2.2% vs 1.8 +/- 2.2%, p = 0.014) and FBG (2.6 +/- 2.6 mmol/l vs 1.4 +/- 2.8 mmo/l, p = 0.004), a decreased glucose response to breakfast compared with acarbose [area under curve (AUC) end: 8.9 +/- 2.7 mmol/l vs 11.3 +/- 3.9 mmol/l, p = 0.0001], and was accompanied by significantly greater compliance (91 or = 12% vs 66 +/- 26%, p = 0.0001). Weight loss during the study was observed in both the acarbose group (1.9 +/- 3.9 kg, p = 0.001) and glimepiride group [0.4 +/- 5.2 kg, p = 0.8 (NS)]. CONCLUSIONS: Improved efficacy and greater compliance were observed in response to treatment with glimepiride compared with acarbose, in patients with Type 2 diabetes. * OBJECTIVE: To assess the efficacy, safety, and dose-response relationship of glimepiride in patients with NIDDM. RESEARCH DESIGN AND METHODS: After a 21-day placebo washou