Sitagliptin Monoterapisi ile Kombinasyon Tedavilerinin Karşılaştırılması

Yıl 2019, Cilt: 45 Sayı: 1, 17 - 21, 01.04.2019

Özen Öz Gül , Pınar Şişman , Soner Cander , Canan Ersoy

https://doi.org/10.32708/uutfd.480706

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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