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二甲双胍、替奈利汀和格列美脲联合治疗2型糖尿病的有效性和安全性:一项准实验性临床试验

Effectiveness and Safety of Metformin, Teneligliptin, and Glimepiride Combination Therapy in Type 2 Diabetes: A Quasi Experimental Clinical Trial.

作者信息

Manchi Rajesh Kumar, Chenchula Santenna, Haritha Manchi

机构信息

Department of Pharmacology, Saraswati Medical College, Unnao, Uttar Pradesh, India.

Department of Pharmacology, T S Misra Medical College, Lucknow, India.

出版信息

Curr Diabetes Rev. 2025;21(6):102-111. doi: 10.2174/0115733998292943240730115310.

Abstract

INTRODUCTION

Type 2 Diabetes Mellitus (T2DM) accounts for more than 95% of all diabetes cases and is a leading cause of disability and death. This study aimed to evaluate the effectiveness and safety of a combination therapy involving metformin, teneligliptin, and glimepiride in patients diagnosed with T2DM.

METHODS

The present quasi-experimental clinical trial involved 300 adult T2DM patients. They were divided into three groups: Group 1 (Metformin; n=100), Group 2 (Metformin + Teneligliptin; n=100), and Group 3 (Metformin + Teneligliptin +; n=100). Along with demographic data, we collected information on HbA1c, FBS, and PPBS levels, as well as fasting insulin, CPeptide, HOMA-IR, QUICKI-IR, and lipid, renal, and hepatic profiles at baseline and after 3, 6, and 12 months. Data analysis was performed using SPSS 21.0 software.

RESULTS

A total of 300 patients participated in the study. At the end of 12 months, triple-drug therapy achieved significant glycemic control (HbA1c: 6.56±0.50%; P<0.0001) and reduced FBS (7.6±1.41 mg/dl; P<0.0001), PPBS (9.39±2.14 mg/dl; P<0.0001), and fasting insulin (11.26±2.5 IU; P<0.0001), C-peptide (2.01±2.29 ng/ml; P<0.0001), and insulin resistance by HOMA-IR (3.74±0.7; P<0.0001). Favorable lipid profiles (P<0.0001) were noted versus other groups. Despite renal and hepatic profile variations, values remained within the normal range.

CONCLUSION

The combination of teneligliptin with metformin and glimepiride in T2DM patients demonstrated significant improvements in glycaemic control, reduced insulin resistance, and positive effects on lipid, renal, and hepatic profiles. Importantly, the therapy did not result in serious adverse drug reactions, such as hypoglycemia. We need more RCTs to substantiate these findings.

摘要

引言

2型糖尿病(T2DM)占所有糖尿病病例的95%以上,是导致残疾和死亡的主要原因。本研究旨在评估二甲双胍、替格列汀和格列美脲联合治疗对确诊为T2DM患者的有效性和安全性。

方法

本项准实验性临床试验纳入了300例成年T2DM患者。他们被分为三组:第1组(二甲双胍;n = 100)、第2组(二甲双胍 + 替格列汀;n = 100)和第3组(二甲双胍 + 替格列汀 + ;n = 100)。除人口统计学数据外,我们在基线以及3、6和12个月后收集了糖化血红蛋白(HbA1c)、空腹血糖(FBS)和餐后血糖(PPBS)水平以及空腹胰岛素、C肽、稳态模型胰岛素抵抗指数(HOMA-IR)、定量胰岛素敏感性检查指数(QUICKI-IR)以及血脂、肾功能和肝功能指标的信息。使用SPSS 21.0软件进行数据分析。

结果

共有300例患者参与了本研究。在12个月末,三联药物治疗实现了显著的血糖控制(HbA1c:6.56±0.50%;P<0.0001),并降低了FBS(7.6±1.41mg/dl;P<0.0001)、PPBS(9.39±2.14mg/dl;P<0.0001)以及空腹胰岛素(11.26±2.5IU;P<0.0001)、C肽(2.01±2.29ng/ml;P<0.0001),同时降低了HOMA-IR评估的胰岛素抵抗(3.74±0.7;P<0.0001)。与其他组相比,血脂情况良好(P<0.0001)。尽管肾功能和肝功能指标有所变化,但数值仍在正常范围内。

结论

在T2DM患者中,替格列汀与二甲双胍和格列美脲联合使用在血糖控制、降低胰岛素抵抗以及对血脂、肾功能和肝功能方面均有显著改善。重要的是,该治疗未导致严重的药物不良反应,如低血糖。我们需要更多随机对照试验来证实这些发现。

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