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題名 | Vildagliptin糖尿病第三線藥療效探討=Efficacy of Vildagliptin as Third Line Therapy of Type 2 Diabetes |
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作者 | 葉盈池; 劉人瑋; 王春玉; 李司方; | 書刊名 | 藥學雜誌 |
卷期 | 30:3=120 2014.09[民103.09] |
頁次 | 頁49-52 |
分類號 | 418.271 |
關鍵詞 | DPP-4抑制劑; 觀察性研究; Vildagliptin; Dipeptidyl peptidase-4 inhibitor; Observational study; |
語文 | 中文(Chinese) |
中文摘要 | 研究目的:提供已經接受 metformin 與 sulfonylurea 類藥品治療的第二型糖尿病 (type 2 diabetes mellitus; T2DM) 病人,加上 DPP-4抑制劑 vildagliptin,對短期血糖控 制影響之探討。 研究設計:回溯性前後對照研究。 研究方法:自某醫學中心電子病歷資料庫收案,收納醫囑 metformin 與 sulfonylurea 類藥品,合併 vildagliptin 之 T2DM 病人,比較加上 vildagliptin 前後,短 期血糖變化。主要試驗終點為加上 vildagliptin 前後 HbA1c 差異,次要終點為前後血 糖控制達標比例差異。 研究結果:研究期間,共收納320位符合收納條件的 T2DM 病人,比較加上 vildagliptin 前後,HbA1c 平均值差異達統計上顯著水準 (-0.4%;P < 0.0001),達標比 例也達統計上顯著差異 (10.3%與16.6%;P = 0.0042)。加上 vildagliptin 前,血糖控制 不佳病人,使用 vildagliptin 後 HbA1c 平均值顯著下降 (-0.6%;P < 0.0001),而加上 前血糖控制較佳病人,再使用 vildagliptin 則無顯著差異。 結論:已接受 metformin 與 sulfonylurea 類藥品的 T2DM 病人,加上 vildagliptin 可顯著改善短期血糖控制,且顯著提高達標比例,特別是加上 vildagliptin 前,血糖控 制不佳之病人。 |
英文摘要 | Objective: To provide data on the short-term glycemic control of patients with type 2 diabetes mellitus (T2DM) treated with dipeptidyl peptidase-4 (DPP-4) inhibitor in addition to metformin and a sulfonylurea. Study design: Retrospective before-and-after study. Method: A cohort was derived from the electronic medical records of a medical center. T2DM patients treated with a DPP-4 inhibitor in addition to metformin and a sulfonylurea were included to compare the short-term glycemic control after vildagliptin was added. Primary study endpoint was the mean changes in HbA1c while the secondary endpoint was the percentage of patients achieving target blood sugar control. Results: The cohort included 320 eligible T2DM patients. The mean changes in HbA1c from baseline was -0.4% reaching statistical significance (paired t-test p < 0.0001). The percentage achieving target blood sugar control was also significantly increased (10.3% vs. 16.6%; p = 0.0042). In patients whose blood sugar levels were inadequately controlled (HbA1c > 8%) with metformin and a sulfonylurea, vildagliptin was associated with signicantlly lower level of HbA1c (-0.6%; p < 0.0001). No significant changes were found in patients with well controlled HbA1c levels. Conculsion: Vildagliptin achieved significantlly better short-term glycemic control and increased the percentage of patients achieving target blood sugar control in T2DM patients treated with metformin and a sulfonylurea, especially in patients whose blood sugar levels were inadequately controlled. |
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