Efficacy of sulfonylurea in combination with metformin or troglitazone in aged patients with non-insulin dependent diabetes mellitus(NIDDM)

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概要

• 論文の詳細を見る

• Efficacy of sulfonylurea in combination with either metformin or troglitazone was investigated in 34 patients with non-insulin dependent diabetes mellitus (NIDDM) without serious diabetic complications. The patients were aged from 48 to 78 yr (mean±SD : 63.9±8.1) with a diabetic history of 5 to 9 yr, in which glycemic control by sulfonylurea alone was unsatisfactory with elevated HbA1c levels (8.0±1.0%). They were assigned to the combination therapy with sulfonylurea and either metformin (750mg/day) (group 1,n=19) or troglitazone (400mg/day) (group 2,n=15) for three months. The baseline characteristics did not differ between groups 1 and 2 before the therapy. In group 1,fasting plasma glucose (FPG) decreased from 147.5±29.4mg/dl to 119.7±24.2ng/ml (P<0.001) and hemoglobin A1c (HbAlc) decreased from 7.9±1.2% to 6.5±0.7% after the combination therapy for three months. In group 2,FPG and HbA1c were also decreased from 161.8±25.4mg/dl to 134.7±20.0mg/dl (P<0.05) and from 8.0±0.7% to 7.2±0.7% (P<0.001), respectively. HbA1c levels were more reduced in group 1 than in group 2 (P<0.02). Fasting plasma C-peptide (CPR) levels were more reduced (P<0.02) in group 2 (from 2.6±0.5 to 1.1±0.5ng/ml, P<0.001) than in group 1 (from 2.7±1.0ng/ml to 1.4±0.5ng/ml, P<0.001). Body mass index (BMI) was decreased in groupl (from 26.1±3.6 to 25.7±3.3,P<0.05) whereas it was not changed in group 2 after the treatment for three months. These findings suggest that sulfonylurea in combination with either metformin or troglitazone is effective for better glycemic control in patients with NIDDM which are not well controlled by sulfonylurea alone, and that metformin is more effective to reduce BMI whereas troglitazone is more effective to reduce plasma CPR without changing BMI in these patients.

• 島根大学の論文

著者

• YAMAMOTO Hiroyuki

  First Department of Internal Medicine, Sapporo Medical University

• Kato Y

  Department Of Endocrinology Metabolism And Hematological Oncology School Of Medicine Shimane Univers

• Kato Yuzuru

  島根大学 医学部内分泌代謝・血液腫瘍内科

• Kato Yuzuru

  島根大学 医学部内分泌代謝･血液腫瘍内科

• Kato Yuzuru

  First Division Department Of Medicine Shimane Medical University

• Nishiki Masateru

  First Division, Department of Medicine, Shimane Medical University

• SOHMIYA Motoi

  First Division, Department of Medicine, Shimane Medical University

• OHGUNI Satoshi

  Department of Internal Medicine, Shimane Medical University

• Kurioka Soichi

  First Division Department Of Medicine Shimane Medical University

• Ohguni Satoshi

  Department Of Medicine Heisei Memorial Hospital

• Sugitani Miyoko

  Department of Medicine, Nita Municipal Hospital

• Sugitani Miyoko

  First Division Department Of Medicine Shimane Medical University

• Nishiki Masateru

  First Division Department Of Medicine Shimane Medical University

• Nishiki Masateru

  First Department Of Internal Medicine Shimane University Faculty Of Medicine

• Yamamoto Hiroyuki

  First Department Of Internal Medicine Sapporo Medical University

• Yamamoto Hiroyuki

  Department Of Pharmacology Wakayama Medical University

• Yamamoto Hiroyuki

  Department Of Microbiology St. Marianna University School Of Medicine

• Kato Yuzuru

  First Division Department Of Medicine Shiman Medical University

• Yamamoto H

  First Department Of Internal Medicine Sapporo Medical University

• Yamamoto Hiroyuki

  First Department Of Internal Medicine Department Of Radiology Sapporo Medical University School Of M

• Ohguni Satoshi

  Department Of Internal Medicine Matsue Municipal Hospital

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