（优质医学）全科医生糖尿病管理要点.ppt

阿卡波糖(acarbose)与优降糖（格列苯脲）联合使用，不但可以改善协调控制，同时减少低血糖发生危险。研究比较安慰剂、阿卡波糖(acarbose)＋优降糖、阿卡波糖(acarbose)、优降糖四组的血糖控制和低血糖发生情况。研究纳入84例2型糖尿病患者 (FPG：120-180 mg/dl；餐后血糖 140-240 mg/dl)。研究在2家中心进行。双盲、安慰剂对照。阿卡波糖(acarbose)剂量为100 mg/日; 优降糖剂量为3.5 mg/日。阿卡波糖(acarbose)＋优降糖可降低餐后血糖(23.7+/-17.3 mg/dl) （与阿卡波糖(acarbose)组相比， 58.4+/-31.6 mg/dl ）、 （与优降糖组相比， 56.9+/-42.8 mg/dl ）、 （与安慰剂组相比， 101.6+/-49.2 mg/dl ）；均达到统计学意义的差异。与优降糖组相比，联合使用拜唐苹(Glucobay)?反而可以降低低血糖的发生危险。 The effect of combination treatment with acarbose and glibenclamide on postprandial glucose and insulin profiles: additive blood glucose lowering effect and decreased hypoglycaemia. Rosak C, Haupt E, Walter T, Werner J. Krankenhaus Sachsenhausen, Inn Med, Frankfurt, Germany. This study compared the effects of acarbose plus glibenclamide combination therapy with acarbose or glibenclamide treatment alone on postprandial blood glucose, serum insulin and C-peptide levels, and the tendency to develop hypoglycaemia. A total of 84 patients with Type 2 diabetes (fasting blood glucose: 120-180 mg/dl; postprandial blood glucose: 140-240 mg/dl) was included in this two-centre, double-blind, double-dummy, placebo-controlled study. Patients were randomised to one of 4 treatment groups: acarbose (100 mg); glibenclamide (3.5 mg); acarbose plus glibenclamide; or placebo. Treatment was administered before a standard breakfast, and fasting (07.30 h, 08.00 h) and postprandial (09.00, 10.00, 11.00, 12.00 h) blood glucose, serum insulin and C-peptide levels were determined. Acarbose plus glibenclamide treatment significantly reduced the mean increase in postprandial blood glucose levels (23.7+/-17.3 mg/dl) compared with either acarbose (58.4+/-31.6 mg/dl), glibenclamide (56.9+/-42.8 mg/dl) or placebo (101.6+/-49.2 mg/dl) (p0.05 for all). Serum insulin levels (mean AUC(7.30-12 h)) observed with acarbose plus glibenclamide combination therapy were significantly lower than those observed with glibenclamide monotherapy (243.5+/-161.1 vs 383.4+/-215.8 hr x microU/ml;