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目的:观察吡格列酮和二甲双胍对2型糖尿病肥胖患者胰岛素抵抗(IR)的影响。方法:2型糖尿病肥胖患者50例,在饮食和运动治疗基础上随机分为吡格列酮组及二甲双胍组,疗程12周。结果:二甲双胍组和吡格列酮在治疗后空腹和餐后 C 肽水平均较用药前有明显降低、IR 亦有降低、β细胞功能明显改善。吡格列酮在降低餐后胰岛素、改善 IR 方面优于二甲双胍,两药物治疗前后血游离脂肪酸水平未见统计学差异。结论:二甲双胍和吡格列酮都可降低 IR 和改善β细胞功能,在降低 IR 方面,吡格列酮优于二甲双胍。
Objective: To observe the effects of pioglitazone and metformin on insulin resistance (IR) in type 2 diabetic obese patients. Methods: Fifty obese patients with type 2 diabetes were randomly divided into pioglitazone group and metformin group on the basis of diet and exercise therapy for 12 weeks. Results: Both fasting and postprandial C-peptide levels in metformin group and pioglitazone group were significantly lower than those before treatment, IR was also decreased, and β-cell function was significantly improved. Pioglitazone is superior to metformin in reducing postprandial insulin and improving IR. There was no significant difference in blood free fatty acid levels between the two drugs before and after treatment. CONCLUSION: Both metformin and pioglitazone can reduce IR and improve β-cell function, and pioglitazone is superior to metformin in reducing IR.