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目的 研究二甲双胍是否能阻止糖耐量减低(IGT),患者转变为2型糖尿病(DM)及其安全性和有效性。方法 56例住院时经OGTT证实为IGT的病人,给二甲双胍250mg,每日3次。观察1～2周后的空腹及餐后2小时血糖。出院治疗1年后随访复查OGTT。结果 56例患者治疗1～2周后空腹血糖由5.88±1.20mmol/L降到4.35±1.30mmol/L,餐后2小时血糖由9.20±0.5mmol/L降到5.80±2.11mmol/L(P<0.01)。1年后随访到34例病人,其中14例坚持服药到随访时(治疗组),20例仅服药1～3月后停药(对照组)。两组复查OGTT结果,对照组OGTT正常者3例(15.0%),仍为IGT者15例(75.0%),转变为DM者2例(10.0%);治疗组OGTT正常者8例(57.2%),仍为IGT者6例(42.8%),无转变为DM者,无低血糖症发生。结论 二甲双胍长期服用可阻止IGT病人恶化为DM,此药安全、有效、不易发生低血糖,易被接受长期服用。但我组病人少尚需继续观察。
AIM To investigate whether metformin can prevent IGT, and change into type 2 diabetes mellitus (DM) and its safety and efficacy. Methods 56 patients were admitted to hospital with OGTT confirmed as IGT patients, metformin 250mg, 3 times a day. Fasting and 2 hours postprandial blood glucose were observed after 1 to 2 weeks. Discharged 1 year follow-up review of OGTT. Results The fasting blood glucose decreased from 5.88 ± 1.20mmol / L to 4.35 ± 1.30mmol / L in 56 patients after 1 ~ 2 weeks of treatment, and decreased from 9.20 ± 0.5mmol / L to 5.80 ± 2.11mmol / L at 2 hours after meal <0.01). One year later, 34 patients were followed up, of which 14 patients insisted on medication until the follow-up (treatment group) and 20 patients stopped taking drugs only after 1 to 3 months (control group). The OGTT results were observed in two groups. There were 3 cases (15.0%) with normal OGTT in control group, 15 cases (75.0%) still in IGT group and 2 cases (10.0%) in DM group. ), Still 6 cases of IGT (42.8%), no change to DM, no hypoglycemia. Conclusion Long-term use of metformin can prevent IGT patients from deteriorating to DM. This medicine is safe, effective and not prone to hypoglycemia, and is easily accepted for long-term use. However, my group still need to continue to observe less.