Maksimum doz oral hipoglisemik ajanlarla optimal glisemik regülasyon sağlanamayan tip 2 diyabetik hastalarda repaglinid-glargin insülin kombinasyonu, akarboz-glargin insülin kombinasyonu ve tek başına glargin insülin tedavilerinin glisemik parametrel
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Date
2006
Authors
Duran, Cevdet
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Tip 2 diyabetik hastalarda hastalık süresi ilerledikçe diyet ve oral antidiyabetik (OAD) tedaviye rağmen kan glukoz regülasyonu sağlanamaz ve sıklıkla insülin tedavisine ihtiyaç duyulur. Son yıllarda sadece insülin tedavisi yerine insülin ve OAD kombinasyonu önerilmektedir. Bu çalışmamızda insülin glargin (IG)'in tek başına, repaglinid veya akarboz ile kombinasyonlarının glisemik parametreler üzerine etkisi araştırıldı.Maksimum doz OAD kullanımına rağmen açlık kan glukozu (AKG) 140 mg/dl,Hemoglobin A1C'si (A1C) %9'un üzerinde olan 20 hastaya IG ve repaglinid (gurup 1), 18 hastaya IG ve akarboz (gurup 2), 10 hastaya ise IG monoterapisi (gurup 3) uygulandı.Üç aylık tedavi sonrası AKG'nda başlangıca göre gurup 1'de %35.29, gurup2'de %37.28, gurup 3'de %5.04 düşüş oldu. Gurup 1 ve 2'de bu düşüş başlangıca ve gurup 3'e göre anlamlıydı. Tokluk kan glukozu gurup 1'de%14.84, gurup 2'de %31.05 azalırken, gurup 3'de %7.79 arttı. Bu değişim sadece gurup 2'de başlangıca ve gurup 3'e göre anlamlıydı. HemoglobinA1C'de gurup 1'de %27.78, gurup 2'de %25.17, gurup 3'de %10.92 düşüş oldu. Tüm guruplarda A1C'de düşüş oranları başlangıca göre ve gurup 1 ve2'de gurup 3'e göre anlamlıydı. Tedaviyle sekiz ölçüm kan glukozu sonuçları gün ortalaması gurup 1 ve 2'de anlamlı olarak azalırken, gurup 3'de arttı. Bu değişim gurup 1 ve 2'de gurup 3'e göre anlamlıydı. Tedavi süresince gurup 1'de başlangıca ve gurup 3'e göre daha fazla kiloartışı oldu. Hipoglisemik atak sıklığı bütün guruplarda benzerdi.Sonuç olarak maksimum doz OAD'lerle glisemik regülasyon sağlanamayan tip 2 diyabetik hastalarda repaglinid ve akarboz'un IG ile kombinasyonu glisemik parametreler üzerine benzer ve olumlu etki göstermektedir.
Eventhough under strict dietary regimen and oral antidiabetic drug (OAD) therapy, blood glucose regulation may not be achived as the duration of the disease prolonged in type 2 diabetes and frequently insulin prescription becomes necessary. Nowadays combinations of insulin and OAD’s are often prescribed instead of insulin alone. In this study the effects of insulin glargine (IG) alone, and combination with repaglinide or acarbose on glycemic parameters were studied. Patients who had blood glucose levels over 140 mg/dl and A1C 9% besides maximum OAD therapy were included in the study. Patients were divided into three groups, according to the therapeutic regimen applied. In group 1; IG and repaglinide were applied to 20 patients, in group 2; IG and acarbose to 18 patiens and in group 3 IG alone to 10 patients. After 3 months of therapy in group 1; 35.29% decrease, in group 2; 37.28% and in group 3; 5.04% decrease were achived in fasting blood glucose levels. The decrease group 1 and 2 were statistically significant compared with begining values and group 3. Postprandial blood glucose levels were decreased in groups 1 and 2 as 14.84% and 31.05%, respectively. Whereas it was increased 7,79% in group 3. It was statistically significant only in group 2 compared to the begining values and to the values of group 3. Blood hemoglobin A1C levels were decreased in all groups as follows; in group 1 decline was 27.78%, in group 2; 25.17%, and in group 3; 10.92%. The decline in A1C were statistically significant in all groups compared with the begining and groups 1 and 2 compared to group 3. At the end of the study; 8 points home blood glucose monitoring mean values were statistically declined in group 1 and 2, whereas it was increased in group 3. This decline was statistically significant in group 1 and 2, compared with group 3. During study, more weight gain was detected in group 1 compared with the beginning and the other groups. Hypoglycemia incidence was similar in all. As a result IG combination with repaglinide or acarbose has similary, positive effect on glycemic parameters in type 2 diabetics, who haven’t been achieved acceptabl glycemic control besides maximum OAD therapy.
Eventhough under strict dietary regimen and oral antidiabetic drug (OAD) therapy, blood glucose regulation may not be achived as the duration of the disease prolonged in type 2 diabetes and frequently insulin prescription becomes necessary. Nowadays combinations of insulin and OAD’s are often prescribed instead of insulin alone. In this study the effects of insulin glargine (IG) alone, and combination with repaglinide or acarbose on glycemic parameters were studied. Patients who had blood glucose levels over 140 mg/dl and A1C 9% besides maximum OAD therapy were included in the study. Patients were divided into three groups, according to the therapeutic regimen applied. In group 1; IG and repaglinide were applied to 20 patients, in group 2; IG and acarbose to 18 patiens and in group 3 IG alone to 10 patients. After 3 months of therapy in group 1; 35.29% decrease, in group 2; 37.28% and in group 3; 5.04% decrease were achived in fasting blood glucose levels. The decrease group 1 and 2 were statistically significant compared with begining values and group 3. Postprandial blood glucose levels were decreased in groups 1 and 2 as 14.84% and 31.05%, respectively. Whereas it was increased 7,79% in group 3. It was statistically significant only in group 2 compared to the begining values and to the values of group 3. Blood hemoglobin A1C levels were decreased in all groups as follows; in group 1 decline was 27.78%, in group 2; 25.17%, and in group 3; 10.92%. The decline in A1C were statistically significant in all groups compared with the begining and groups 1 and 2 compared to group 3. At the end of the study; 8 points home blood glucose monitoring mean values were statistically declined in group 1 and 2, whereas it was increased in group 3. This decline was statistically significant in group 1 and 2, compared with group 3. During study, more weight gain was detected in group 1 compared with the beginning and the other groups. Hypoglycemia incidence was similar in all. As a result IG combination with repaglinide or acarbose has similary, positive effect on glycemic parameters in type 2 diabetics, who haven’t been achieved acceptabl glycemic control besides maximum OAD therapy.
Description
Keywords
Tip 2 diyabet, İnsülin glargin, Repaglinid, Akarboz, Sekonder yanıtsızlık, Type 2 diabetes, Insulin glargine, Repaglinide, Acarbose, Secondary failure
Citation
Duran, C. (2006). Maksimum doz oral hipoglisemik ajanlarla optimal glisemik regülasyon sağlanamayan tip 2 diyabetik hastalarda repaglinid-glargin insülin kombinasyonu, akarboz-glargin insülin kombinasyonu ve tek başına glargin insülin tedavilerinin glisemik parametrel. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.