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6 233 /...+#, -%.% /!" )*% (# ( #( 5 <= >12 4 5&67./ 8 P-value* # $% # $% U/O8 NU/H }V/H??N/V }??/HH FS U/9 /NO 8O/N H?/UV V/98 S (4pM) <U/UUUH O/8?O/OH?N/HU }8/?H U/UUV??/U?/NN /U }O/9? Hb1c U/??? O/O O/NN H/UU?/V U/UV HH/8?/9U 8N/HN }H/UU!2 U/9V?O/O8 }?/?H?N/ /UV 22!/ U/U9H 9/8V }N/8 8U/NH N/9U LDL ) 3, Hb 1. QRS < %F&/ 3 % (</O%) <, G;.-% / + %& &/ (/ 2, Hb 1 T2 #] 7 4=; 6+ 3, Hb 1 h[] - =; / #] %- 2% =;,-,3 3 &/ < 7 g 2 % q w/y (HUUmg/dl).- =; Hb 1 &/ (/ %?O/H 2, 3, FY / D ()* (9/8u/d), S / % S (/ (/u/d) %8,& (/ -%, QRS < w 5i2, S 3, Hb 1 (/ %?H/V (/ > (8) F& D.-% 3 $ 6 & (U) F& [.,/ l) 3 )* (/ 22 (?) Eviles, Sant, Raskin, Sinding 3 )* %?O %?H ~ /./ l) Type 2 6 & +,& ()*.-% =; q S & =; ()*.6 `- /,& / & (N),/ 6* 6* (?E?H) troglitazone (?OE?8), g3.6,- l) /%!2 2, FY (P=U/N), Z[ (P=U/?N). S ()* 8mg/dl.(P=U/UV) - %= >) H* ), F & F.2 F&, %&!k ) 0 % - %7 3,/ Z: & 8 2.S %R, 2 3/ 3 / %/-./ g&12 I F!&] 3 5i2 =; & 6+ %;1 6Y (?EUE9ENEE) # $ 6 (?) > $ 6 # $ 6 & 3 5i2. #!= 3 /.6, 2QRS 3 / %!+ 412 =;.6./% i2 QRS + 3,/ 6*, / (/ K /H 3,/ 6*,.6 - T2 2, FY. S Hb 1 %!+ 4=; &/ (/.S, %:RS &/ %N Hb 1 3,. (?EU) % z e[ / (/ / 2,

7 "#>/ "*" 8#%, Hb 1 (/ \] 3 / *^, ( %N/ V / 6+ &/ ()* &/ %8N.- gky 2, #!/ /V 3, =; & % S ()* #!/ 8 2 /, S &/ ()*,/ 6*.+ QRS z T2 1. Dagogo-lack S, santiago jv. Pathophysiology of type 2 diabetes and modes of action of therapeutic interventions. rth Intern med 1997; 157: Melander. oral antidiabetic drugs an overview. Diabetes med 1996; 13(9 suppl 6): s Scheen. Drug treatment of non-insulin dependent diabetes mellitus in the 1990 chievements and future developments. Durgs. 1997, 54: braira, owell, Nuttal FQ, Nagel N, onstock P, etal. Veteran affairs ooperative Study on glycemic control and complication in Type II diabetes (V SDM). Results of the feasibility trail. Veterans ffairs cooperative study in Type 2 diabetes. Diabetic care. 1995; 18: Herny RR, Gumbiner, Dizeler T, wallace P. lyon R, Gluaber HS Intensive onventional insulin therapy for type2 diabetes. Metabolic effects during a 6 mo outpatient Trail. Diabetes care. 1993; 16: ailey. Turner R. Metformin N Engl med: 1996; 334; Sirtory RS, pasik. Re-evaluation of a biguanide, metfomin. Mechanism of action and tolerability. Pharmacol Res 1994, 334; Davidson M, Peters L. n overview of metformin in the treatment of type 2 diabetes mellitus. m med 1997: Grarber, Duncon TG, Goodman M, mills D, Rohlt L. Double blind, placebo- ontrolled, dose-response trail. m of med 1997:102:494-7 in glycamic control and reduction of metabolic risk factors. Eur clin phrmacol. 1993; 44: Giugliiano D.Quatraro, cosol: G, minei, ceriello et al. metformin for obese, insulintreated diabetic patients. 11. Defronzo R, Goodman M. Efficacy of metformin in patients with non-insulin dependent diabetes mellitus. The Multicenter metformin Study Group. N Engle med: 1995, 333: Lefebure P, scheen. Improving the action of insulin. lin invest med. 1995; 18: b Pagano G, Tagliaferro V, carata Q, aselle MT, ozzoc, uitellif, et al. Metformin reduces requirements in type 1 (insulin-dependent)diabetes. Diabetologia 1983; 24:

8 23: /...+#, -%.% / 14. Defronzo R, arzilai N, Simonson D. Mechanism of metformin action in obese and lean non insulin-dependent diabetic subject. Sclin Endocrinol metab. 1991; 73: United Kingdom Prospective Diabetes Study 24:6-year, randomized, control trail comparing sulfonylurea, insulin, and metformin therapy in patients with newly diagnosed Type2 diabetes that could not be controlled with diet Therapy. United Kingdom Prospective Diabetes study grou. nn intern med. 1998; 128: Scheen, letiexhe MR, Letebure P. Effects of metformin in obese patients with impaired glucose tolerance. Diabetes Metab Rev. 1995; 11: Effect of intensive blood-glucose control with metformin on complications in overweight patients ith Type2 diabetes (UKPDS). UK prospective Diabetes Study (UKPDS) GROUP. Lancet: 1998; 325: Laissa viles-santa, MD; oyce sinding, MSN, RN; and philip Raskin, MD. nn Intern Med. 1999; 131: ergenstal R, ohnson M, whipple D, Nolle D, oycek, Roth L, et al. dvantages of adding metformin to multiple dose in insulin therapy in type 2 diabetes.!" )*% 20. Gigliano Quatraro, onsoli G, Minei, eriello, De Rosa N, etal Metformin for obese insulin treated diabetic Patients; improvement in glycemic control and reduction of metabolic risk factors, Eur ckin Pharmacol. 193; 44: viles-sant, sinding, Raskin P. The effects of metformin in poorly controlled insulin-treated type 2 diabetes mellitus. [bstract]. Diabetes. 1998; 47(suppl(1): International Diabetes Federation ongress, November 5-10, 2000, Mexico city, Mexico. 23. ahnson L. Wolf sl, kababi um. Efficacy ot insulin and suftonglurea combination therapy in Type 2 diabetes. meta-analysis of randomized placebo-ontrolled trials. rch Inten Med. 1996; 156: Halimi S, corticelli P,enhamou PY. ombination of insulin and snlfonyfureas. literature review. m Med Dogogo-ack S,Santiago V. Pathopysiology of type 2 diabetes and modes of action of therapeutic interventions. rch Intern Med. 1997; 157: Saltil R, Olefski M. Thiazolidinediones in the treatment of insulin resistance and type 2 diabetes. Diabetes 1996; 45:

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