Sitagliptin Monoterapisi ile Kombinasyon Tedavilerinin Karşılaştırılması

Öz

Çalışmamızda sitagliptinin monoterapide ve kombinasyon (metformin veya pioglitazon) tedavilerinde kullanımlarının glisemik kontrol, lipid profili ve insülin direnci üzerine etkilerinin karşılaştırılması amaçlanmıştır. Yeni tanı almış ve daha önce antidiyabetik tedavi almamış olan toplam 46 tip 2 diyabetik hasta çalışmaya dahil edildi. Hastalara rastgele olarak sitagliptin (grup 1), sitagliptin+metformin (grup 2), sitagliptin+pioglitazon (grup 3) tedavileri başlandı. Tedavide sitagliptin 100mg/gün, metformin 2000mg/gün ve pioglitazon 30mg/gün dozlarında kullanıldı. Altı aylık izlem süresini tüm hastalar tamamladı. Hastalar başlangıçta ve çalışma sonunda antropometrik ölçümler, glisemik parametreler ve lipid düzeyleri açısından değerlendirildi. Hastaların başlangıç antropometrik ölçümleri, glisemik parametreleri ve lipid profilleri benzerdi. Altıncı ay sonunda yapılan değerlendirmede grup 1’de istatistiksel anlamlı vücut kitle indeksi (VKİ) düşüşü gözlenirken, grup 2 ve 3’te istatistiksel anlamlı değişiklik saptanmadı. Hemoglobin A1c her üç grupta da istatistiksel olarak anlamlı düzeyde azaldı, gruplar arasında ise istatistiksel anlamlı farklılık saptanmadı. Altıncı ay sonunda serum trigliserid düzeyleri grup 3’te anlamlı olarak azalırken diğer lipid profili üzerine etkileri açısından her üç grup arasında farklılık saptanmadı. HOMA-IR değerlendirildiğinde 6 ay sonunda grup 1 ve grup 2’de farklılık saptanmazken, grup 3’te anlamlı azalma olduğu görüldü (p<0.05). Çalışmamız sonucunda sitagliptin monoterapisi sitagliptin+metformin ve sitagliptin+pioglitazon kombinasyon tedavilerinin glisemik değerler ve lipid profili üzerine olan etkileri benzerdi. Sitagliptin pioglitazon kombinasyon tedavisinin insülin direnci ve trigliserid düzeylerini düşürmede daha üstün olduğu saptanmıştır.

Anahtar Kelimeler

• Tip 2 diyabet,insülin direnci,sitagliptin,pioglitazon

Comparison of Sitagliptin Monotherapy with Combination Therapy

Öz

The aim of this study was to compare the effects of sitagliptin in monotherapy and combination (metformin or pioglitazone) treatments on glycemic control, lipid profile and insulin resistance. A total of 46 type 2 diabetic patients, who were newly diagnosed and who had not previously received antidiabetic therapy, were included in the study. Patients were randomly assigned to receive sitagliptin (group 1), sitagliptin + metformin (group 2) or sitagliptin + pioglitazone (group 3). Sitagliptin 100 mg/day, metformin 2000 mg/day and pioglitazone 30 mg/day were used in the treatment. All patients completed the six-month follow-up period. Patients were evaluated at baseline and at the end of the study in terms of anthropometric measurements, glycemic parameters and lipid levels. Initial anthropometric measurements, glycemic parameters and lipid profiles were similar. At the end of the sixth month, a statistically significant decrease in body mass index (BMI) was observed in group 1, while there was no statistically significant difference in group 2 and 3. Hemoglobin A1c was significantly decreased in all three groups and no statistically significant difference was found between the groups. Serum triglyceride levels were significantly decreased in group 3 at the end of the sixth month and no difference was found between the three groups in terms of their effects on the other lipid profile. When HOMA-IR was evaluated, there was no significant difference in group 1 and group 2 at the end of 6 months, whereas there was a significant decrease in group 3 (p <0.05). The effects of sitagliptin monotherapy, sitagliptin+metformin and sitagliptin+pioglitazone combination treatments on glycemic values and lipid profile were similar. Sitagliptin+pioglitazone combination therapy was found to be superior in reducing insulin resistance and triglyceride levels.

Anahtar Kelimeler

• Type 2 diabetes,insulin resistance,sitagliptin,pioglitazone

Kaynakça

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