二甲双胍的抗衰老效果与饮食密切相关

本文从二甲双胍已知的降血糖功效引入,解读分析多篇文章,了解二甲双胍的作用机理以及饮食因素对药效的调节作用,得到了营养物质影响二甲双胍药效的结论,摄取糖类对二甲双胍的吸收有间接影响,并进一步分析抗衰老药物问世的可能性.     

Cost-effectiveness of metformin plus vildagliptin compared with metformin plus sulphonylurea for the treatment of patients with type 2 diabetes mellitus: a Portuguese healthcare system perspective

Objective:

To evaluate the cost-effectiveness of vildagliptin plus metformin vs generic sulphonylurea plus metformin in patients with type 2 diabetes mellitus, not controlled with metformin, from a Portuguese healthcare system perspective.

Methods:

A cost-effectiveness model was constructed using risk equations from the UK Prospective Diabetes Study Outcomes Model with a 10,000-patient cohort and a lifetime horizon. The model predicted microvascular and macrovascular complications and mortality in yearly cycles. Patients entered the model as metformin monotherapy failures and switched to alternative treatments (metformin plus basal-bolus insulin and subsequently metformin plus intensive insulin) when glycated hemoglobin A1c >7.5% was reached. Baseline patient characteristics and clinical variables were derived from a Portuguese epidemiological study. Cost estimates were based on direct medical costs only. One-way and probabilistic sensitivity analyses were conducted to test the robustness of the model.

Results:

There were fewer non-fatal diabetes-related adverse events (AEs) in patients treated with metformin plus vildagliptin compared with patients treated with metformin plus sulphonylurea (6752 vs 6815). Addition of vildagliptin compared with sulphonylurea led to increased drug acquisition costs but reduced costs of AEs, managing morbidities, and monitoring patients. Treatment with metformin plus vildagliptin yielded a mean per-patient gain of 0.1279 quality-adjusted life years (QALYs) and a mean per-patient increase in total cost of €1161, giving an incremental cost-effectiveness ratio (ICER) of €9072 per QALY. Univariate analyses showed that ICER values were robust and ranged from €4195 to €16,052 per QALY when different parameters were varied.

Limitations:

The model excluded several diabetes-related morbidities, such as peripheral neuropathy and ulceration, and did not model second events. Patients were presumed to enter the model with no diabetes-related complications.

Conclusion:

Treatment with metformin plus vildagliptin compared with metformin plus sulphonylurea is expected to result in a lower incidence of diabetes-related AEs and to be a cost-effective treatment strategy.     

奥利司他与二甲双胍联用对肥胖型2型糖尿病患者的疗效及对体重指数、胰岛β细胞功能指数、胰岛素抵抗指数水平的影响

目的 探讨奥利司他与二甲双胍联用对肥胖型2型糖尿病(T2DM)患者的疗效及对体重指数(BMI)、胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)水平的影响.方法 选取2018年2月至2020年2月大连市第四人民医院收治的肥胖型T2DM患者83例作为研究对象,按随机数字表法分为联合组41例与对照组42...     

甘精胰岛素联合二甲双胍治疗2型糖尿病的临床疗效

目的探讨甘精胰岛素联合二甲双胍治疗2型糖尿病的临床疗效。方法选取2型糖尿病患者66例,将其随机分为观察组和对照组各33例,观察组患者服用二甲双胍+甘精胰岛素皮下注射治疗;对照组患者仅服用二甲双胍进行治疗,两组患者治疗16周后,检测空腹血糖(FBG)、餐后2 h血糖(2 h BG)、C肽水平及糖化血红蛋白(Hb A1c)。结果两组患者经治疗后FBG、2 h BG、Hb A1c均明显下降,与治疗前比较差异有统计学意义(P<0.05),同时观察组较对照组下降明显(P<0.05)。观察组患者C肽水平明显高于对照组(P<0.05)。结论甘精胰岛素联合二甲双胍具有良好的降糖效果,同时能改善胰岛功能,减少低血糖发生,安全有效。