伏格列波糖治疗以低血糖为首发表现的2型糖尿病或IGT患者疗效分析.doc

PAGE PAGE 1 - 伏格列波糖治疗首发低血糖的2型糖尿病 和IGT患者的临床研究 季明 张征 邹大进 【摘要】 目的：观察以低血糖(hypolycemia)为首发表现的糖耐量异常（IGT）和新诊断的2型糖尿病(T2DM)患者应用伏格列波糖以后血糖波动的改善情况。方法：随访自2009年11月至2014年3月我院收治的36例以低血糖为首发表现的IGT和2型糖尿病患者，应用伏格列波糖治疗3个月后6个时间点的血糖水平，胰岛素水平，C肽水平，及低血糖发作次数和发作时血糖最低值，以评价疗效。结果：伏格列波糖治疗12周后，IGT患者餐后低血糖症群完全消失10例(占58.82％)；DM患者治疗后，低血糖症群完全消失11例(占57.89%)，低血糖发作次数减少70%以上为15例（占41.61%）。OGTT试验显示治疗后0.5-2小时血糖的高峰下降缓慢，2-4小时胰岛素、C肽值则显著下降，（P0.0001）。结论：伏格列波糖(voglibose)可明显改善以低血糖为首发表现的2型糖尿病或IGT患者血糖波动,预防低血糖的发生。 【关键词】伏格列波糖；特发性餐后低血糖症 Abtract:Objective: To explore the improvement of blood glucose fluctuation in IGT patients presented with hypoglycemia or newly diagnosed patients with type 2 diabetes and IGT treated with voglibose.Methods: Total 36 IGT patients presented with hypoglycemia and patients with type 2 diabetes were enrolled from November 2009 to March 2014.Then they were treated with voglibose for 3 months; and their blood glucose levels, insulin, c-peptide levels, the number of hypoglycemia occurrence and the lowest blood sugar when hypoglycemia were detected.Results:?After treatment with voglibose for 12 weeks, 10 IGT patients with postprandial hypoglycemia recovered (58.82%); 11 DM patients with postprandial hypoglycemia recovered (57.89%), and the number of hypoglycemia occurrence decreased more than 70%,15（41.61%）. OGTT test showed that after treatment with voglibose the cliff of?blood-sugar level?decreased much slowly after treatment during 0.5 to 2 hours, the blood sugar rush down slowly, insulin level (2-4 hours) and C peptide level decreased significantly (P0.0001).Conclusion: Voglibose can improve the fluctuations of blood glucose in IGT and diabetic patients with hypoglycemia, and prevent the occurrence of hypoglycemia. 【Keywords】: voglibose; idiopathic postprandial hypoglycemia 流行病学统计2型糖尿病(T2DM)病人全球发病率持续大幅增加，目前全球共有糖尿病患者约2亿，而预计到2025年则患病人数可达到3亿，我国最新流行病学 ＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿ 作者单位：第二军医大学长海医院内分泌科，邮编：200433 通信作者：邹大进 ?第二军医大学肥胖与糖尿病专病诊疗中心 电子邮箱： zwjd22@ 基金项目：国家自然科学基金资助项目（资助号 调查显示，成人糖尿病发病率为9.7%