不同剂量盐酸吡格列酮对胰岛素敏感性的影响

目的：研究2型糖尿病病人应用不同剂量盐酸吡格列酮对血糖控制、胰岛素敏感性和胰岛素分泌的影响。方法：30名单纯饮食、运动治疗无效或单用磺脲类药物治疗无效的2型糖尿病病人，随机、双盲给予15或30mg／d国产盐酸吡格列酮治疗12周，对治疗前后的各项疗效指标进行观察分析。结果：(1)15或30mg／d吡格列酮降低空腹血糖及糖化血红蛋白效果良好，两组间差异无统计学意义；(2)15mg／d吡格列酮治疗前后空腹胰岛素水平及稳态模型评估的胰岛素抵抗(HOMA—IR)指数无变化，30mg／d吡格列酮治疗前后空腹胰岛素水平及HOMA—IR均明显下降。结论：吡格列酮可有效地降低2型糖尿病病人的空腹血糖及糖化血红蛋白，耐受性好；吡格列酮对胰岛素敏感性的改善存在剂量依赖性。

Effects of different dosages of pioglitazone hydrochloride on insulin sensitivity of patients with diabetes

Objective: To investigate the effects of different dosages of pioglitazone on glycemic control, insulin sensitivity, and insulin secretion in patients with type 2 diabetes. Methods: Thirty patients with type 2 diabetes were randomly and double-blindly assigned to receive 15 or 30 mg of pioglitazone hydrochloride per day for 12 weeks. Before and after treatment, fasting plasma glucose and insulin, HbA1c, HOMA insulin resistance(HOMA-IR) index were determined. Results: (1) Patients treated with 15 or 30 mg/day of pioglitazone hydrochloride had no difference in the decrease of fasting plasma glucose and HbA1c. (2) There was no difference in fasting plasma insulin and HOMA-IR index before and after the treatment of 15 mg/day of pioglitazone hydrochloride. Patients treated with 30 mg/day of pioglitazone hydrochloride had significant decreases from baseline in fasting plasma insulin and HOMA-IR index. Conclusion: Two dosages of pioglitazone hydrochloride decrease effectively and safely the fasting plasma glocuse and HbA1c in patients with type 2 diabetes. There is a dose-dependent effect of pioglitazone hydrochloride on insulin sensitivity.