格列齐特联合阿卡波糖治疗老年2型糖尿病临床观察

目的:探讨格列齐特缓释片联合阿卡波糖片治疗老年2型糖尿病临床疗效。方法:选择68例符合诊断标准的老年2型糖尿病,给予格列齐特缓释片30~90mg每天1次,早餐前或后服用;阿卡波糖25~50mg餐时嚼服,每日1~3次,共观察12周。结果:治疗12周后患者空腹血糖、餐后2小时血糖、HbA1c、HOMA-IR均明显下降,HOMA-β明显提高,与治疗前比较差异有统计学意义(P0.05)。结论:格列齐特缓释片联合阿卡波糖片能有效治疗老年2型糖尿病。     

格列齐特、甲钴胺及其联合用药对糖尿病大鼠周围神经形态学改变及神经生长因子含量的影响

目的观察格列齐特、甲钴胺及其联合用药对糖尿病大鼠周围神经形态学改变及神经生长因子含量的影响。方法采用链脲佐菌素致糖尿病大鼠模型,以组织学方法观察药物对糖尿病大鼠坐骨神经形态学改变的影响;以酶联免疫方法测定血清中神经生长因子含量;以免疫组织化学法观察坐骨神经组织内神经生长因子的含量变化。结果格列齐特、甲钴胺及其联合用药对糖尿病大鼠坐骨神经形态学改变有保护作用;对血清神经生长因子含量减少有提高作用;对坐骨神经组织中神经生长因子的含量虽无明显影响,但对坐骨神经轴突内神经生长因子的减少有提高作用。格列齐特与甲钴胺联合应用对以上指标的改善均未发现有明显性提高。结论格列齐特、甲钴胺及其联合用药对糖尿病大鼠周围神经病变具有保护作用;与单独用药相比,格列齐特与甲钴胺联合应用未见有明显性疗效增强作用。     

中药制剂及保健品中违禁添加9种化学降糖药的HPLC-MS/MS定性检测

建立了HPLC-MS／MS方法定性检测中药制剂及保健品中违禁添加的盐酸二甲双胍、盐酸苯乙双胍、盐酸吡格列酮、格列吡嗪、格列齐特、格列本脲、格列美脲、格列喹酮、瑞格列奈共9种降糖化学药物。采用LichroCARTC18色谱柱，0．1％甲酸溶液（用氨水调至pH3．5）和乙腈梯度洗脱，检测波长230nm，流速0．2ml／min，选择正离子检测。上述9种药物的检出限为1-5ng。     

Optimal dosing of gliclazide—A model-based approach

Gliclazide was approved as a treatment for type 2 diabetes in an era before model-based drug development, and consequently, the recommended doses were not optimised with modern methods. To investigate various dosing regimens of gliclazide, we used publicly available data to characterise the dose-response relationship using pharmacometric models. A literature search identified 21 published gliclazide pharmacokinetic (PK) studies with full profiles. These were digitised, and a PK model was developed for immediate- (IR) and modified-release (MR) formulations. Data from a gliclazide dose-ranging study of postprandial glucose were used to characterise the concentration–response relationship using the integrated glucose–insulin model. Simulations from the full model showed that the maximum effect was 44% of the patients achieving HbA1c <7%, with 11% experiencing glucose <3 mmol/L and the most sensitive patients (i.e., 5% most extreme) experiencing 35 min of hypoglycaemia. Simulations revealed that the recommended IR dose (320 mg) was appropriate with no efficacy gain with increased dose. However, the recommended dose for the MR formulation may be increased to 270 mg, with more patients achieving HbA1c goals (i.e., HbA1c <7%) without a hypoglycaemic risk higher than the resulting risk from the recommended IR dose.