Prospective comparative study in NIDDM patients of metformin and glibenclamide with special reference to lipid profiles

Summary. Twenty-two NIDDM patients completed an open randomized cross-over study comparing metformin and glibenclamide over 1 year.The drugs had an equivalent effect on glycaemic control, but, in contrast to glibenclamide, metformin reduced body weight. Neither drug affected triglycerides, total-and LDL-cholesterol or C-peptide. Metformin caused a slight elevation of HDL-cholesterol (P < 0.05). No serious adverse effects were observed.The results show that oral hypoglycaemic agents are not associated with undesirable effects on lipids and lipoproteins.     

血管紧张素原基因M235T多态性对NIDDM患者发生高血压的影响

目的 研究血管紧张素原（ＡＧＴ）基因Ｍ２３５Ｔ多态性对ＮＩＤＤＭ患者发生高血压的影响。方法 用限制性普分析法检查ＡＧＴ基因Ｍ２３５Ｔ多态性Ｍ２３５和Ｔ２３５的频率和ＴＴ、ＴＭ和ＭＭ基因型在正常对照组（６８例）、糖悄病非高血压组（１０４例）和糖尿病高血压组（８７例）中的分布，并检查各基因型对实验对象血压水平的影响。结果 糖尿病高血压组患者ＡＧＴ基因Ｍ２３５Ｔ多态性Ｔ２３５的频率明显高于对照组和糖尿病     

The effects of one month high fructose intake on plasma glucose and lipid levels in non-insulin-dependent diabetes

The effects of a high fructose diet on the control of blood glucose and serum lipids were studied in 10 non-insulin-dependent diabetic patients (mean age 64.4 years, mean duration of diabetes 5.6 years). Comparison was made following 28 days on the usual diabetic diet and 28 days during which 25% of the usual carbohydrate was substituted with fructose. There was no change in mean (+/- SEM) fasting plasma glucose (on usual diet 9.2 +/- 0.5 mmol/l, on fructose diet, 9.1 +/- 0.4 mmol/l), but there was a fall in mean plasma glucose levels at 30, 60, and 120 min in a 75 g OGTT following the fructose diet. There was no significant change in fasting lipids: on usual diet mean serum cholesterol 5.8 +/- 0.2 mmol/l, on fructose diet 5.6 +/- 0.2 mmol/l; serum triglyceride, on usual diet 1.3 +/- 0.1 mmol/l, on fructose diet 1.3 +/- 0.1 mmol/l; HDL cholesterol on usual diet 1.4 +/- 0.1 mmol/l, on fructose diet 1.4 +/- 0.1 mmol/l. Mean body weight did not vary significantly between the two diets. Incorporation of fructose into the diabetic diet may lower post-prandial glucose levels without disturbing serum lipids.     

NIDDM家族史与儿童肥胖及血压间的相关研究

为研究ＮＩＤＤＭ家族史与儿童肥胖度，体脂分布及血压的关系，方法我们对１６０８名７－１３岁儿童进行ＮＩＤＤＭ家族史调查及儿童形态指标，血压的测量。结果儿童ＮＩＤＤＭ家族史阳性率１７．４１％，有ＮＩＤＤＭ家族史儿童与无ＮＩＤＤＭ家族儿童相比，体块指数更大，差异有显著性意义；体重更，更为肥胖；两组儿童体脂分布类型及血压判别无显著性。结论 儿童肥胖与ＮＩＤＤＭ相关密切。     

α-Glucosidase inhibitors in diabetes: efficacy in NIDDM subjects

With α-glucosidase inhibitors generally improved metabolic control is achieved in NIDDM patients regardless of whether acarbose is administered in addition to other oral anti-diabetic agents or to diet alone. The most significant finding is the reduction of postprandial blood glucose concentrations. Long-term studies show a decrease in glycosylated haemoglobin and often also in fasting blood glucose levels. Placebo-controlled studies have proven that postprandial insulin concentrations are decreased under acarbose treatment while fasting plasma insulin is usually unchanged. The major side-effects of acarbose treatment involve the gastrointestinal system and include flatulence, abdominal discomfort and diarrhoea. Symptoms diminish with treatment time and are less severe when the treatment is started with low doses. Acarbose should usually be initiated as a 50 mg dose immediately before each major carbohydrate containing meal. Monotherapy with acarbose does not cause hypoglycaemia, however, hypoglycaemia may occur with combination of sulphonylurea or insulin treatment by the well-known reasons. In this case hypoglycaemia has to be treated by taking glucose.     

NIDDM患者血清生长激素,C肽水平与微血管病变的关系

本文测定了20例NIDDM患者血清GH、C肽水平并观察其与视网膜病变及肾脏病变的关系。结果表明有视网膜病变组血GH水平明显高于无视网膜病变组,C肽水平在两组中无明显变化。提示糖尿病患者血GH水平增高与微血管病变有一定关系。     

血糖控制不良的非胰岛素依赖型糖尿病患者胃排空时间测定

本文以双核素标记试餐ＳＰＥＣＴ显像技术，检测了１５例血糖控制不良的非胰岛素依赖型糖尿病（ＮＩＤＤＭ）患者的胃排空时间，结果显示：ＮＩＤＤＭ组液体排空曲线与对照组相似，呈指数相排空；固体排空曲线则不同于正常人的双相性曲线，而类似于液体排空曲线。１２例（８０％）无延迟时间（Ｐ＜０．００５）。９例（６０％）ＮＩＤＤＭ患者胃排空时间异常，其中固体半排空时间（Ｔ５０）延长者７例，固、液体Ｔ５０均延长和均缩短者各１例。固体Ｔ５０延长者归为一亚组，病程和血糖与固体Ｔ５０均有显著相关性。因此，ＮＩＤＤＭ患者以固体胃排空异常为主；对于那些长期血糖控制不良者有必要研究其胃排空功能；双核素标记试餐ＳＰＥＣＴ显像技术是较敏感的检测手段。     

Postmarketing study of nateglinide in Japan: treatment of medication-naïve patients with type 2 diabetes

Nateglinide is an oral antidiabetic medication (OAD) that acts through rapid, short-term stimulation of insulin production. This study was conducted to identify the nature of any adverse effects associated with nateglinide and to evaluate its clinical efficacy in patients with type 2 diabetes, with particular attention to hypoglycemia. Patients with type 2 diabetes who were OAD naïve (n=547), whose fasting blood glucose levels were 150 mg/dL or lower, and who had started to take nateglinide alone were recruited from 139 centers in Japan with a 12-week observation period. The incidence of adverse reactions was 7.62%. Hypoglycemia accompanied by hypoglycemic symptoms was the most prevalent adverse event (2.10%; 11/525). Nine of 11 episodes required no therapeutic intervention. Severe hypoglycemia was recognized in only 1 case of diabetes complicated by serious renal dysfunction, for which nateglinide has been contraindicated in Japan. No subject experienced symptoms of nocturnal or prolonged hypoglycemia. After 12 weeks of nateglinide treatment, decreases were noted in hemoglobin A_1c (0.82%), postprandial glucose (reduced by 59.4 mg/dL to 158.0 mg/dL), and fasting glucose (reduced by 11.7 mg/dL to 122.4 mg/dL). Nateglinide, which demonstrates limited risk of hypoglycemia and effectively controls blood glucose level, is regarded as a useful drug for the treatment of patients with type 2 diabetes.