4种降糖药对2型糖尿病血清铁蛋白水平的影响

目的比较重组人胰岛素、吡格列酮、那格列奈和瑞格列奈4种药物对2型糖尿病(T2DM)患者血清铁蛋白水平的影响。方法58例T2DM患者分为4组,分别接受4种药物84 d的治疗。治疗前、后测定空腹血糖(FBG)、糖化血红蛋白A1 c(HbA1 c)及血清铁蛋白。结果重组人胰岛素组、吡格列酮组和瑞格列奈组的FBG和HbA1 c均有明显下降(P<0.05),其中重组人胰岛素组的HbA1 c下降值大于其他两组(P<0.05)。重组人胰岛素组及瑞格列奈组的血清铁蛋白水平有显著性下降(P<0.05及P<0.01,吡格列酮组下降接近统计学水平(P=0.052)。那格列奈组的FBG、HbA1 c和血清铁蛋白水平均有下降趋势,但差异无统计学意义(P>0.05)。分别对4组的FBG和HbA1 c与血清铁蛋白水平变化进行相关性分析,未发现明显的相关性(P>0.05)。结论重组人胰岛素、瑞格列奈治疗T2DM患者84 d,降低了血清铁蛋白水平,未发现血清铁蛋白水平的下降与血糖水平的下降相关。     

甘精胰岛素联合口服药治疗初诊2型糖尿病临床观察

目的：观察甘精胰岛素联合瑞格列奈及二甲双胍治疗初诊2型糖尿病的临床疗效及安全性。方法：对40例初诊的2型糖尿病患者分为对照组20例和治疗组20例。所有患者均接受了同等糖尿病知识的教育,予饮食控制、运动治疗及血糖监测。对照组采用皮下注射预混胰岛素,2次/d;治疗组在口服瑞格列奈、二甲双胍的基础上加用甘精胰岛素皮下注射,1次/晚,疗程均为12周。12周后比较两组治疗前后组内及组间的FPG、2 h PG、HbAlc、BMI及低血糖频率、程度等情况。结果：治疗前两组患者各项观察指标差异无统计学意义（P>0.05）,治疗后两组患者FPG、2 h PG、HbAlc显著下降,比较差异有统计学差异（P<0.05）;BMI具有增加趋势,但对照组增加更明显;治疗组低血糖频率低于对照组,比较差异有统计学意义（P<0.05）。结论：联合应用甘精胰岛素、瑞格列奈、二甲双胍治疗初诊2型糖尿病有较好的疗效,且不良反应较少,患者依从性好,值得临床推广。     

瑞格列奈与阿卡波糖治疗2型糖尿病疗效比较研究

目的：比较瑞格列奈与阿卡波糖治疗2型糖尿病患者的临床疗效。方法：将120例单纯饮食运动治疗不满意的2型糖尿病患者随机分为瑞格列奈组60例（A组）和阿卡波糖60例（B组）,疗程12周。测定并比较两组治疗前后空腹血糖（FPG）、餐后2小时血糖（2hPG）,糖化血红蛋白（HbA1C）,空腹及餐后胰岛素（FINS,P2hINS）,血脂和体重指数（BMI）。结果：瑞格列奈组FBG平均下降3.84mmol·L-1,疗效优于阿卡波糖组（下降2.90mmol·L-1）,两组P〈0.01;两种药物对2hBG均有明显地降低作用（P〈0.01）,且降低程度相似;两组HbA1C均能显著降低,两组比较HbA1C降低的幅度无显著性差异（P〉0.05）;餐后2小时血清胰岛素与治疗前比较瑞格列奈组升高有显著性差异（P〈0.01）,而阿卡波糖组明显降低（P〈0.01）,治疗12周后瑞格列奈组BMI略上升1.3%（P〉0.05）,阿卡波糖组BMI降低2.6%（P〈0.05）,两组间比较有显著性差异（P〈0.05）。阿卡波糖能使甘油三酯和低密度脂蛋白明显降低（P〈0.01）。结论：瑞格列奈和阿卡波糖均能明显降低空腹和餐后血糖以及HbA1C。瑞格列奈降低空腹血糖的作用优与阿卡波糖,而阿卡波糖可减低餐后胰岛素分泌,调节血脂,减轻体重,更适合肥胖患者。     

甘精胰岛素联合瑞格列奈治疗2型糖尿病的临床效果观察

目的探讨甘精胰岛素联合瑞格列奈治疗2型糖尿病的临床效果。方法选取本院2013年2月～2014年2月收治的78例2型糖尿病患者作为研究对象,根据治疗方法不同将其分为实验组和对照组,每组各39例。对照组采用胰岛素皮下注射进行治疗,实验组应用甘精胰岛素联合瑞格列奈治疗,比较两组患者的治疗效果。结果两组治疗后的HbA1c、2hPG、FPG水平均较治疗前显著降低（P〈0．05）;实验组治疗后的HbA1c水平显著低于对照组（P〈0．05）,两组治疗后的2hPG、FPG水平比较,差异无统计学意义（P〉0．05）。实验组的总有效率为97．4％,显著高于对照组的79．5％（P〈0．05）。结论甘精胰岛素联合瑞格列奈治疗2型糖尿病能有效维持血糖稳定性,降低胰岛素用量,减少低血糖的发生,是一种较为理想的治疗方案,值得推广应用。     

阿卡波糖与瑞格列奈联合二甲双胍治疗2型糖尿病餐后高血糖的效果观察

摘 要 目的：比较阿卡波糖与瑞格列奈分别联合二甲双胍治疗2型糖尿病餐后高血糖的效果。方法: 160例餐后高血糖的糖尿病患者随机分为阿卡波糖组与瑞格列奈组,每组80例。分别给予阿卡波糖联合二甲双胍治疗与瑞格列奈联合二甲双胍治疗8周。比较两组治疗前后血糖、糖化血红蛋白（HbA1c）、胰岛素、血脂与体质指数（BMI）等指标的变化,以及两组药品不良反应发生情况。结果: 治疗后,两组患者空腹血糖（FPG）、餐后2 h血糖（2hPG）及HbA1c水平均较治疗前明显降低（P<0.05）,且瑞格列奈组FPG水平明显低于阿卡波糖组（P<0.05）。治疗后,瑞格列奈组空腹胰岛素、餐后2 h胰岛素水平均较治疗前明显上升（P<0.05）,而阿卡波糖组则较治疗前明显降低（P<0.05）;两组间比较差异有统计学意义（P<0.05）。治疗后,阿卡波糖组三酰甘油、低密度脂蛋白胆固醇水平和BMI均较治疗前明显降低（P<0.05）,而瑞格列奈组上述指标治疗前后比较差异无统计学意义（P＞0.05）;两组间比较差异有统计学意义（P<0.05）。瑞格列奈组药品不良反应发生率明显低于阿卡波糖组（P<0.05）。结论:阿卡波糖与瑞格列奈联合二甲双胍均降低2型糖尿病患者餐后高血糖,瑞格列奈降低FPG作用优于阿卡波糖,而阿卡波糖能使患者餐后胰岛素、血脂及BMI降低,对肥胖患者更为适合。     

A comparison of repaglinide and glibenclamide in the treatment of type 2 diabetic patients previously treated with sulphonylureas

Objective: To compare the efficacy and safety of repaglinide, a novel oral prandial glucose regulator, with that of glibenclamide, an oral hypoglycaemic agent, in the treatment of patients with type 2 diabetes. Methods: This was a 14-week, double-blind, parallel-group trail in which a total of 195 type 2 diabetic patients treated with oral hypoglycaemic agents were randomized to receive either repaglinide, administered preprandially three times daily, or glibenclamide, given preprandially once or twice daily, as per manufacturer's recommendations. Results: By the end of the study, the 2-h postprandial blood glucose values were lower in the repaglinide group than in the glibenclamide group, with the difference approaching statistical significance (repaglinide, 8.1 (0.6) mol · 1⁻¹ vs glibenclamide, 9.1 (0.6) mmol · 1⁻¹; P = 0.07). There was no statistically significant difference in the mean blood glucose level at the end of the study between the two groups (repaglinide, 7.1 (0.5) mmol · 1⁻¹ vs glibenclamide, 7.4 (0.5) mmol·1⁻¹; P = 0.42), and baseline HbA_1C values had decreased to the same degree in both the repaglinide [7.8% (0.1%) to 7.5% 0.1%)] and the glibenclamide groups [8.0 (0.1%) to 7.6 (0.1%)]. There are no significant differences between the repaglinide and glibenclamide treatment groups in the levels of fasting blood glucose, fructosamine, fasting C-peptide, insulin and proinsulin. Neither treatment group showed any clinically significant changes in blood lipid profiles. Repaglinide and glibenclamide were both well tolerated. No significant differences were observed between the two treatment groups with respect to adverse events, including hypoglycaemic episodes and weight change. No accumulation of repaglinide was apparent during the maintenance period. Conclusion: Repaglinide is as well tolerated as glibenclamide and is equally effective in the management of type 2 diabetes. Repaglinide may, however, offer an improvement in postprandial blood glucose control compared with glibenclamide, thereby helping to reduce the relative long-term risk of diabetic complications. Received: 14 January 1998 / Accepted in revised form: 3 December 1998     

Effect of repaglinide on cloned beta cell, cardiac and smooth muscle types of ATP-sensitive potassium channels

Aims/hypothesis. The carbamoylbenzoic acid derivative repaglinide is a potent short-acting insulin secretagogue that acts by closing ATP-sensitive potassium (K_ATP) channels in the plasma membrane of the pancreatic beta cell. In this paper we investigated the specificity of repaglinide for three types of cloned (K_ATP) channel composed of the inwardly rectifying potassium channel Kir6.2 and either the sulphonylurea receptor SUR1, SUR2A or SUR2B, corresponding to the beta cell, cardiac and either smooth muscle types of K_ATP channel, respectively. Methods. The action of the drug was studied by whole-cell current recordings of K_ATP channels expressed either in Xenopus oocytes or mammalian cells (HEK293). We also used inside-out macropatches excised from Xenopus oocytes for detailed analysis of repaglinide action. Results. The drug blocked all three types of K_ATP channel with similar potency, by interacting with a low-affinity site on the pore-forming subunit of the channel (Kir6.2: half-maximal inhibition 230 μmol/l) and with a high-affinity site on the regulatory subunit, the sulphonylurea receptor (SUR: half-maximal inhibition 2–8 nmol/l). There was no difference in potency between channels containing SUR1, SUR2A or SUR2B. MgADP potentiated the inhibitory effect of repaglinide on Kir6.2/SUR1 and (to a lesser extent) Kir6.2/SUR2B, but not on Kir6.2/SUR2A. Conclusion/interpretation. Repaglinide interacts with a site common to all three types of sulphonylurea receptor leading to inhibition of the K_ATP channel. The fact that MgADP potentiated this effect in the case of the beta cell, but not cardiac, type of channel could help explain why the drug shows no adverse cardiovascular side-effects in vivo. [Diabetologia (2001) 44: 747–756] Received: 13 December 2000 and in revised form: 14 February 2001     

两种促胰岛素分泌剂对血糖漂移的影响

目的 交叉对比分析瑞格列奈和格列齐特的动态血糖图谱，观察比较血糖波动系数、低血糖发生率和餐后血糖峰值。方法T2DM患者52例，分别应用瑞格列奈或格列齐特，常规检查血糖。采用交叉设计，应用瑞格列奈组患者改用格列齐特，应用格列齐特组患者改用瑞格列奈，改用前后分别予动态血糖监测72h。原有饮食运动及联用口服药物不变。以用瑞格列奈为研究组，用格列齐特为对照组，对比分析两组血糖波动系数、低血糖发生率和餐后血糖峰值。结果经2周洗脱期、8周剂量调整期、2周剂量维持期、3d监测期后的结果显示：应用瑞格列奈比应用格列齐特血糖控制更平稳，动态血糖图谱表现为血糖波动系数小，低血糖次数少，低血糖时间比少（P〈0．01），餐后血糖峰值低（P＜0．05）。结论本研究条件下，应用瑞格列奈比应用格列齐特似可减少血糖漂移幅度。     

盐酸二甲双胍与瑞格列奈联用治疗糖尿病的临床效果研究

目的探究盐酸二甲双胍与瑞格列奈联用对糖尿病的临床治疗效果,提高盐酸二甲双胍与瑞格列奈联用的医疗价值。方法2018年1月—2019年6月,将120例糖尿病患者随机划分成观察组和对照组,并对观察组糖尿病患者予以盐酸二甲双胍与瑞格列奈联用治疗,对对照组糖尿病患者予以普通治疗方式,之后结合多方面数据信息对比分析观察组和对照组糖尿病患者临床治疗效果。结果通过多方面对比分析,可以看出通过盐酸二甲双胍与瑞格列奈联用治疗的糖尿病临床治疗效果明显高于普通治疗方法的糖尿病临床治疗效果,观察组与对照组之间差异有统计学意义(P<0.05)。结论对糖尿病患者开展盐酸二甲双胍与瑞格列奈联用治疗,能够在减缓患者糖尿病恶化速率的条件下,提高相应疾病综合治疗效果,这对于我国医学行业良性发展也起到非常重要的作用。     

甘精胰岛素联合瑞格列奈治疗老年2型糖尿病的疗效观察

目的观察老年2型糖尿病(T2DM)病人甘精胰岛素联合瑞格列奈降糖治疗的效果。方法 60例T2DM患者随机分为甘精组和预混组,甘精组三餐前15 min口服瑞格列奈0.5～1.0 mg,晚10∶00皮下注射甘精胰岛素。预混组于早晚饭前30 min注射预混胰岛素,应用罗康全血糖仪,住院期间监测空腹、三餐后2 h、夜10∶00、夜3∶00指尖血糖,根据血糖调整胰岛素剂量。空腹血糖(FPG)<7.0 mmol/L,餐后2 h血糖(2 hPG)<10.0 mmol/L为达标。观察血糖达标时间、胰岛素用量、低血糖发生次数、发生人数;12周后的FPG、2 hPG、糖化血红蛋白(HbAlc)、体质量指数(BMI)。结果两组血糖控制均达标,预混组和甘精组12周后,FPG2、hPG、HbA1c组间差异无统计学意义(P>0.05),组内与治疗前相比差异有统计学意义(P<0.01)。两组血糖达标时间差异无统计学意义(P>0.05),甘精组BMI较治疗前无明显增加(P>0.05),预混组BMI较治疗前明显增加(P<0.05)。甘精组胰岛素日用量、低血糖发生人数显著低于预混组(P<0.01),差异有统计学意义。结论两种治疗方案对控制血糖都有效,但甘精胰岛素联合瑞格列奈降糖治疗方案能减少注射次数和胰岛素的日用量,减少低血糖风险,不增加体质指数,依从性好。