二甲双胍对肥胖糖耐量低减患者干预治疗的研究

对100例肥胖糖耐量低减患,随机分组,进行饮食、运动或二甲双胍干预治疗。结果：对照组（饮食运动）轻度改善,无显性差异（P＞0．05）。治疗组（小剂量二甲双胍）,体重指数、血糖、血脂治疗前后显下降（P＜0．05）,胰岛素敏感性指数显增加（P＜0．01）。结论：小剂量二甲双胍可以减轻肥胖IGT的胰岛素抵抗,使其恢复正常 糖耐量状态。     

二甲双胍对肥胖糖耐量低减患者干预治疗的研究

对100例肥胖糖耐量低减患者,随机分组,进行饮食、运动或二甲双胍干预治疗.结果对照组(饮食运动)轻度改善,无显著性差异(P＞0.05).治疗组(小剂量二甲双胍),体重指数、血糖、血脂治疗前后显著下降(P＜0.05),胰岛素敏感性指数显著增加(P＜0.01).结论小剂量二甲双胍可以减轻肥胖IGT者的胰岛素抵抗,使其恢复正常糖耐量状态.     

二甲双胍对葡萄糖耐量低减的干预治疗

葡萄糖耐量低减(IGT)是介于正常血糖和2型糖尿病(T2DM)之间的一种特殊代谢状态,WHO关于IGT最新诊断标准是空腹血浆葡萄糖＜7 mmol/L(126 mg/dL)、7.8 mmol/L≤葡萄糖负荷后2 h血浆葡萄糖＜11.1 mmol/L(140 mg/dL和200 mg/dL).     

小剂量二甲双胍对肥胖糖耐量低减患者的干预治疗的研究

糖耐量低减 (ＩＧＴ)是发展为 2型糖尿病的重要阶段 ,这个阶段在早期通过干预治疗是可逆的。但单纯生活方式的干预效果在很大程度上受人群胰岛素抵抗程度轻重的限制 ,尤其是肥胖ＩＧＴ患者 ,需要实行药物干预治疗。我们采用小剂量二甲双胍对肥胖ＩＧＴ患者进行短期干预治疗 ,以评价小剂量二甲双胍对胰岛素抵抗为主的肥胖ＩＧＴ患者的干预治疗效果。对象与方法1 对象 :10 0例均为 1998年 1月～ 2 0 0 0年 6月 ,从普查和健康体检中经口服葡萄糖耐量确诊的ＩＧＴ患者。入选标准是 2次检测空腹血糖值ＦＰＧ 5 5～ 7 7ｍｍｏｌ/Ｌ ,ＯＧＴＴ 2ｈ…     

二甲双胍:2型糖尿病治疗的基础药

糖尿病是一种临床常见多发的慢性代谢疾病，严重危害着人类健康与生命。糖尿病的药物治疗对控制血糖和延缓并发症发生十分重要，其中二甲双胍在2型糖尿病药物治疗中具有基石地位。     

二甲双胍对2型糖尿病心脑血管危险因素的干预作用

目的 探讨二甲双胍对2型糖尿病心脑血管危险因素的干预作用。方法 选取426例2型糖尿病患者，随机分为治疗组和对照组，予胰岛素、磺脲类或α-糖苷酶抑制剂等常规治疗，治疗组加用二甲双胍降糖治疗，血糖稳定正常水平，随访3年，比较两组的体重指数（BMI）、空腹血糖（FPG）、餐后2h血糖（2hPG）、糖化血红蛋白（HbA1c）、空腹胰岛素（FINS），血压、血脂、血液流变学、尿素氮（BUN）、血肌酐（Cr）、心脑血管疾病的发生率。结果治疗组BMI、FPG、2hPG、HbA1c 、FINS、血脂、血液流变学、心脑血管疾病的发生率均有明显下降（P〈0．05）。结论 二甲双胍可改善患者的胰岛素抵抗、降低血糖、血压、血脂、改善纤溶系统．延缓糖尿病心脑血管病变的发生具有重要意义。     

那格列奈和二甲双胍联合用药治疗2型糖尿病疗效的比较

72例2型糖尿病患者随机分为：二甲双胍组36例服用二甲双胍片0．5g／次。3次／日。联合治疗组36例，加用那格列奈60mg／次，3次／日；二甲双胍片0．25g／次，3次／日。疗程均为12周。结果：餐前血糖及餐后2小时血糖，差异有显著性，HbAlc下降更明显，且促进早期胰岛素的分泌。结论：那格列奈与二甲双胍合用疗效比单用二甲双胍好。     

瑞格列奈联合二甲双胍治疗2型糖尿病肥胖观察

对50例初发肥胖2型糖尿病给予瑞格列奈联合二甲双胍治疗12周，治疗前、后检测体重指数（BMI）、空腹血糖（FBG）、餐后血糖（PRG）、胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL—C）、高密度脂蛋白胆固醇（HDL-C）。结果 BMI、FBG、PBG、TC、TG、LDL-C均降低，HDL—C升高。结论 瑞格列奈联合二甲双胍治疗肥胖2型糖尿病有效。     

二甲双胍对葡萄糖耐量低减的干预治疗

IGT者发病率高，而且肥胖、高血压以及高脂血症患病率也较高，该人群心脑血管疾病发病危险性显著增加。因此，IGT阶段进行早期干预治疗势在必行。二甲双胍被认为是胰岛素增敏剂之一，能够改善胰岛素抵抗，对血糖、血压、血脂、肥胖等的有益作用均得以肯定。本文对二甲双胍在IGT治疗中的作用及其机制做一综述。     

The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1)

Aims/hypothesis Lifestyle modification helps in the primary prevention of diabetes in multiethnic American, Finnish and Chinese populations. In a prospective community-based study, we tested whether the progression to diabetes could be influenced by interventions in native Asian Indians with IGT who were younger, leaner and more insulin resistant than the above populations. Methods We randomised 531 (421 men 110 women) subjects with IGT (mean age 45.9±5.7 years, BMI 25.8±3.5 kg/m²) into four groups. Group 1 was the control, Group 2 was given advice on lifestyle modification (LSM), Group 3 was treated with metformin (MET) and Group 4 was given LSM plus MET. The primary outcome measure was type 2 diabetes as diagnosed using World Health Organization criteria. Results The median follow-up period was 30 months, and the 3-year cumulative incidences of diabetes were 55.0%, 39.3%, 40.5% and 39.5% in Groups 1–4, respectively. The relative risk reduction was 28.5% with LSM (95% CI 20.5–37.3, p=0.018), 26.4% with MET (95% CI 19.1–35.1, p=0.029) and 28.2% with LSM + MET (95% CI 20.3–37.0, p=0.022), as compared with the control group. The number needed to treat to prevent one incident case of diabetes was 6.4 for LSM, 6.9 for MET and 6.5 for LSM + MET. Conclusions/interpretation Progression of IGT to diabetes is high in native Asian Indians. Both LSM and MET significantly reduced the incidence of diabetes in Asian Indians with IGT; there was no added benefit from combining them. Electronic Supplementary Material Supplementary material is available for this article at     

肥胖者胰岛素分泌功能对糖耐量低减及糖尿病发生的影响

目的　探讨肥胖者胰岛素分泌变化对糖耐量低减 (IGT)及糖尿病 (DM)发生的影响。　方法　对 30例单纯性肥胖 [体重指数 (BMI) >2 7]患者进行血糖和胰岛素测定 ,并观察胰岛细胞分泌指数 (HOMA- IS)及胰岛素敏感性指数 (IAI) ,并对这些患者进行 15年随访。　结果　肥胖者空腹胰岛素 (FINS)水平明显高于正常人 (P <0 .0 1) ,与 HOMA - IS明显的正相关 (P <0 .0 1) ;空腹血糖(FPG)与 HOMA- IS及 IAI呈明显的负相关 (P<0 .0 1)。15年内 6 3.3%的肥胖者发展成 IGT,5 0 .0 %的肥胖者及发展成 IGT者发展为 2型 DM。　结论　肥胖对 IGT及糖尿病的发生、发展有着明显的影响 ,控制体重是减少 IGT发生的重要环节。     

硫化氢对老年空腹血糖调节受损和2型糖尿病的影响

目的 通过检测老年空腹血糖调节受损（IFG）和2型糖尿病患者的血清硫化氢（H2S）水平,探讨气体分子H2S在老年空腹血糖调节受损和2型糖尿病中的临床意义.方法 2型糖尿病患者66例,空腹血糖调节受损患者36例,正常对照组33例,检测入选者的血清H2S浓度.结果 与对照组相比,空腹血糖调节受损患者和2型糖尿病患者HOMA-IR指数明显升高[（3.24±0.93）、（2.34±1.12）比（1.70±1.10）,P＜0.05]、HOMA-β指数降低[（76.41±26.20）、（36.13±23.37）比（93.00±40.46）,P＜0.05],血清H2S水平明显升高[（60.93±12.95）、（63.64±10.96）比（50.07±10.85） μmol/L,P＜0.05].Pearson相关分析结果显示,H2S浓度与空腹血糖调节受损组和糖尿病组患者HOMA-β均呈显著负相关（γ值分别为-0.65、-0.69,P＜0.05）,与HOMA-IR均呈显著正相关（γ值分别为0.73、0.76,P＜0.05）.结论 内源性H2S可能通过抑制β细胞功能和增强胰岛素抵抗参与空腹血糖调节受损和2型糖尿病的发病过程.     

Influence of endogenous hyperinsulinism on high density lipoprotein2 level in type 2 (non-insulin-dependent) diabetes mellitus and impaired glucose tolerance

We determined the insulin response to an oral glucose ingestion and levels of serum lipoproteins in 25 untreated patients with type 2 diabetes mellitus, in 26 subjects with impaired glucose tolerance (IGT), and in 35 non-diabetic control subjects. The three groups had similar compositions with respect to age and sex distribution. The levels of VLDL triglycende in the subjects with type 2 diabetes or IGT were higher than those in controls. Serum HDL- and HDL₂ cholesterol were significantly decreased in type 2 diabetics, and the subjects with IGT showed a similar tendency. Serum apolipoprotein A-II levels were lower in the male subjects with type 2 diabetes or IGT than in controls. Insulin reponse, i.e., sum of immunoreactive insulin (IRI) levels at basal, 30, 60, 90 and 120 min after a 75-g oral glucose load, negatively correlated to HDL and HDL₂ cholesterol levels (r = −0.396, P < 0.05; r = −0.482, P < 0.001, respectively), and positively correlated to VLDL triglyceride values (r = 0.485, P < 0.001) in the male subjects with type 2 diabetes or IGT. In the female subjects, fasting plasma IRI values significantly correlated to HDL cholesterol (r = −0.496, P < 0.05). There was a significant negative correlation between the concentrations of HDL₂ cholesterol and VLDL trgglyceride. These data show that lipoprotein metabolism, not only in type 2 diabetics, but also in IGT tends to show changes such as decreased HDL₂ cholesterol and increased VLDL triglyceride levels, and which might be related to the hypersecretion of endogenous insulin.     

Incidence of impaired glucose regulation and progression to type 2 diabetes mellitus in the Tayside region of Scotland

This study assessed incidence of impaired glucose regulation (IGR) and progression to type 2 diabetes (T2D) in adults in one region of Scotland using routinely collected health-care data. Incidence of IGR was 2720 per 100,000 person years. Nine percent of IGR patients progressed to T2D in a mean time of 34 months.     

Effects of 6 vs 3 eucaloric meal patterns on glycaemic control and satiety in people with impaired glucose tolerance or overt type 2 diabetes: A randomized trial

Background/objectives

The study aimed to compare the effects of two eucaloric meal patterns (3 vs 6 meals/day) on glycaemic control and satiety in subjects with impaired glucose tolerance and plasma glucose (PG) levels 140–199 mg/dL at 120 min (IGT-A) or PG levels 140–199 mg/dL at 120 min and >200 mg/dL at 30/60/90 min post-oral glucose load on 75-g OGTT (IGT-B), or overt treatment-naïve type 2 diabetes (T2D).

Distinguishing between persistent and transient impaired glucose tolerance using a prediction model.

Screening for impaired glucose tolerance (IGT) and Type 2 (non-insulin dependent) diabetes was carried out in 777 people and those with high blood glucose levels completed three 2-h oral glucose tolerance tests (OGTT). Blood lipid levels, fasting and 2-h insulin levels, body mass index, and blood pressure were also measured and family history of Type 2 diabetes recorded. Fifty people were identified with IGT and of these 21 were found to have persistent IGT and 29 transient IGT. A model including the variables body mass index, fasting and 2-h insulin levels, fasting triglycerides and family history of Type 2 diabetes was developed using the Speigelhalter-Knill-Jones weighting method to predict subjects with persistent IGT. This model could be useful in identifying people with persistent IGT and therefore eliminate the need for repeat OGTTs which are time consuming and expensive.     

糖代谢异常和糖尿病患者脉压的研究

目的:脉压与心脑血管疾病相关,糖代谢异常和2型糖尿病也是心脑血管疾病的危险因子,但是脉压与糖代谢异常、2型糖尿病的关系未见在我国人群中的研究报道。方法:对2 420例常规健康体检者进行血浆总胆固醇、甘油三酯、收缩压、舒张压、脉压和体重指数(BMI)测定,观察脉压与糖代谢异常和2型糖尿病的关系。为了避免年龄对脉压的影响,我们将所有被检查者以年龄分为3组(40~54岁组、55~69岁组和≥70岁组)。结果:40~54岁者脉压、收缩压、舒张压、BMI和甘油三酯在糖代谢异常和2型糖尿病组明显升高(P<0.01),总胆固醇在各组之间差异无显著性(P>0.05)。55~69岁者只有脉压在糖代谢异常和2型糖尿病组中明显升高(P<0.05)。年龄≥70岁组中,所有观察指标在各组之间差异均无显著性(P>0.05)。结论:脉压在年龄<70岁的糖代谢异常和2型糖尿病患者中升高。脉压升高预示着心脑血管疾病危险因素的存在。     

老年糖耐量低减及新诊断2型糖尿病胰岛素抵抗及胰岛β细胞功能的研究

目的　了解老年糖耐量低减 (IGT)及新诊断的 2型糖尿病 (T2 DM)患者胰岛素抵抗 (IR)及 β细胞的功能状态。方法　对 32例口服葡萄糖耐量正常者 (NGT)、34例 IGT及 45例 T2 DM患者测定口服葡萄糖耐量试验 (OGTT)各点血糖、胰岛素等指标 ,计算 HOMA模型胰岛素抵抗指数 (HOMA- IR)、β细胞功能指数 (HOM- Aβ)、胰岛素敏感性指数 (ISI)并进行统计学比较。结果　 NGT、IGT、T2 DM组 HOMA- IR分别为 0 .74±0 .75、0 .84± 0 .90、1 .2 6± 0 .79,T2 DM与 NGT比较差异有显著性 (P=0 .0 33)。 NGT、IGT、T2 DM组 HOM- Aβ分别为 5.2 7± 0 .88、5.0 4± 0 .64、4.38± 0 .91 ,其中 T2 DM组与 NGT及 IGT组比较差异均有显著性 ,分别为 P=0 .0 0 1及 P=0 .0 2 2。在 OGTT试验中 IGT组 1 2 0 min胰岛素及 1 80min胰岛素显著高于 NGT组 ,分别为 1 2 8.3± 90 .0 m IU/ L,69.6± 49.3 m IU/ L,P=0 .0 1 9;62 .1± 70 .1 m IU/ L,2 7.1± 2 4 .8m IU/ L ,P=0 .0 30。结论　老年 T2 DM表现出显著的 IR及胰岛β细胞功能减退。老年 IGT作为 T2 DM的前期 ,表现出餐后的异常高胰岛素血症     

Serum sialic acid in subjects with impaired glucose tolerance and in newly diagnosed type 2 diabetic patients

Several general population studies and those carried out in diabetic patients with complications have pointed to serum sialic acid as a marker of inflammation in atherosclerosis. In this study we examined whether total sialic acid (TSA) was changed in the sera of 28 newly diagnosed subjects with type 2 diabetes (type 2 DM), 47 subjects with impaired glucose tolerance (IGT) and 72 subjects with normal glucose tolerance (NGT). The associations between sialic acid and other atherosclerotic risk factors such as lipid profile, baseline diene conjugates in low-density lipoproteins (LDL-BDC) and fasting insulin were also investigated. We found a trend to TSA increase in subjects with impaired glucose tolerance and a significant increase in TSA in newly diagnosed patients with type 2 DM (2.2±0.3 vs. 1.9±0.3 mmol/l; p<0.03) when compared to subjects with NGT. Lipid profile and LDL-BDC, as a marker of circulating oxidized LDL, did not differ among glucose tolerance categories. Significant associations between total sialic acid and 2-h post-load glucose level, fasting insulin, insulin sensitivity, HDL-cholesterol and log of triglycerides were found in the examined subjects. Multiple regression analysis showed significant correlations between serum sialic acid and 2-h post-load glucose levels and insulin sensitivity. This study indicates that measurement of TSA as a marker of subclinical inflammation may be valuable as an independent parameter in identifying subjects at higher risk of developing type 2 diabetes and those who might benefit from anti-inflammatory treatment. Received: 10 May 2002 / Accepted in revised form: 15 April 2003 Correspondence to M. Gavella