WONCA研究论文摘要汇编——青春期2型糖尿病血糖控制临床试验

发布时间：2018-01-27 10:39

本文关键词： 二甲双胍血糖控制型糖尿病罗格列酮生活方式胰岛素治疗青少年青春期干预儿童　出处：《中国全科医学》2012年26期 　论文类型：期刊论文

【摘要】：背景尽管青春期2型糖尿病患病率有所上升,但用于指导治疗的现有资料很少,我们对比了3种疗法对儿童和青少年新发2型糖尿病患者血糖控制的效果。方法本研究入选患者需符合以下条件:10～17岁、用二甲双胍(1 000 mg,2次/d)治疗、糖化血红蛋白(HbA1c)8%;将患者随机分配到单用二甲双胍治疗组、二甲双胍+罗格列酮(4 mg,2次/d)组、二甲双胍+生活方式干预(通过饮食和运动减轻体质量)组。主要结果为血糖控制失败,即HbA1c水平不低于8%并持续6个月,或持续代谢失代偿需用胰岛素治疗。结果对入选的699例患者(2型糖尿病的平均病程为7.8个月)平均随访3.86年,发现有319例(45.6%)患者血糖失控。单用二甲双胍治疗组、二甲双胍+罗格列酮组、二甲双胍+生活方式干预组的失控率分别为51.7%(120/232)、38.6%(90/233)和46.6%(109/234)。二甲双胍+罗格列酮组的疗效优于单用二甲双胍(P=0.006);二甲双胍+生活方式干预组的疗效居中,但与单用二甲双胍治疗组和二甲双胍+罗格列酮组比较,疗效无明显差异。按照性别和种族进一步分析显示,三种疗法的长期疗效有差异,非西班牙裔黑人参试者单用二甲双胍治疗的效果最差,女性参试者用二甲双胍+罗格列酮效果最好。有19.2%的参试者发生了严重不良事件。结论近半数的2型糖尿病儿童和青少年,其血糖控制与二甲双胍单药疗法相关。在不强调生活干预的情况下,加用罗格列酮治疗的效果优于单用二甲双胍治疗。
[Abstract]:Background although the prevalence of type 2 diabetes in adolescence has increased, there is little information available to guide treatment. We compared the effects of three treatments on blood glucose control in children and adolescents with newly diagnosed type 2 diabetes. Treated with metformin 1 000 mg / d, glycosylated hemoglobin (HbA1) 8; Patients were randomly assigned to the metformin treatment group and the metformin rosiglitazone 4 mg / d group. Metformin lifestyle intervention (reducing body mass through diet and exercise). The main result was a failure of blood glucose control, i.e., HbA1c level was no less than 8% and lasted for 6 months. Results the mean course of disease of 699 patients with type 2 diabetes mellitus was 7.8 months and the mean follow-up was 3.86 years. A total of 319 patients (45.6%) were found to have lost control of their blood glucose. The patients were treated with metformin alone and in the metformin rosiglitazone group. The rate of loss of control in the metformin lifestyle intervention group was 51.7 / 232). The curative effect of metformin rosiglitazone group was better than that of metformin rosiglitazone group alone. The therapeutic effect of metformin lifestyle intervention group was middle, but there was no significant difference between the treatment group and the group treated with metformin rosiglitazone, according to the gender and race further analysis showed that the therapeutic effect of metformin lifestyle intervention group was higher than that of metformin treatment group and metformin rosiglitazone group. There were differences in long-term outcomes among the three treatments, with non-Hispanic black participants having the worst effect on metformin alone. Metformin rosiglitazone was the most effective for female participants. 19.2% of the participants had severe adverse events. Conclusion nearly half of the children and adolescents with type 2 diabetes were treated with metformin rosiglitazone. The effect of rosiglitazone plus rosiglitazone was better than that of metformin alone.
【作者单位】：中国石油中心医院;
【分类号】：R587.1
【正文快照】： 原文见:TODAY Study Group.A Clinical Trial to Maintain Glycemic Control in Youth with Type 2 Diabetes[J].N EnglJ Med,2012,366:2247-2256.published at http://www.nejm.org/doi/full/10.1056/NEJMoa1109333WONCA研究论文摘要汇编——青春期2型糖尿病血糖控制临床试验

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