Efficacies of metformin combined with sitagliptin or repaglinide in treatment of obese patients with type 2 diabetes mellitus

Wu Jinchan; Chen Juan; Feng Guangqiu

doi:10.3760/j.issn.1673-4777.2019.05.019

Abstract：Objective To investigate the efficacies of metformin combined with sitagliptin or repaglinide in treating obese patients with type 2 diabetes mellitus. Methods From January 2017 to April 2018,100 obese patients with type 2 diabetes in Hainan General Hospital were randomly divided into control group and observation group,with 50 cases in each group. The control group took metformin plus repaglinide on the basis of routine treatment. The observation group took metformin plus sitagliptin on the basis of routine treatment. Body mass index,blood glucose, insulin resistance,blood lipids,serum serine protease inhibitor(vaspin) ,leptin and adiponectin were detected before and 3 months after treatment. Adverse reactions were observed. Results Before treatment,the measurements were similar between groups(P > 0.05). After 3 months of treatment,body mass index,fasting blood glucose,2 h postprandial blood glucose,glycosylated hemoglobin,insulin resistance index,triglyceride,total cholesterol, low-density lipoprotein cholesterol,vaspin and leptin levels significantly decreased and high-density lipoprotein cholesterol and adiponectin levels significantly increased compared to those before treatment; body mass index,total cholesterol,low-density lipoprotein cholesterol,vaspin and leptin levels in observation group were lower than those in control group[(23.0 ±2.7) kg/mg2 vs (25.7 ± 2.8) kg/mg2,(3.1 ± 0.4) mmol /L vs (4.2 ± 0.5) mmol /L,(2.21 ±0.26) mmol /L vs (2.71 ±0.34) mmol /L,(1.31 ± 0.15) μg/L vs (2.20 ± 0.24) μg/L,(5.5 ± 0.6) μg/L vs (7.2 ±0.8) μg/L]; high-density lipoprotein cholesterol and adiponectin levels in observation group were higher than those in control group[(1.52 ±0.19) mmol /L vs (1.27 ± 0.18) mmol /L,(8.2 ± 0.9) mg/L vs (4.1 ± 0.4) mg/L](all P <0.01). There was no significant difference of the incidence of adverse reactions between groups (P > 0.05 ). Conclusions Metformin plus sitagliptin or repaglinide can effectively regulate blood glucose. Sitagliptin is effective in reducing body mass and blood lipids,regulating serum vaspin,leptin and adiponectin.