Whitelaw D C, Clark P M, Smith J M, Nattrass M
Diabetes Resource Centre, University Hospitals (Selly Oak), Birmingham, UK.
Diabet Med. 2000 Mar;17(3):225-9. doi: 10.1046/j.1464-5491.2000.00256.x.
The new non-sulphonylurea oral hypoglycaemic agent nateglinide has been shown to enhance insulin secretion in animals and in healthy human volunteers and thus offers a potential advance in the treatment of Type 2 diabetes mellitus. This study examined whether nateglinide can enhance insulin secretion, and particularly the first phase insulin response, in patients with Type 2 diabetes.
A double-blind, placebo-controlled trial, examining the effects of a single oral dose of 60 mg nateglinide, given 20 min prior to an intravenous glucose tolerance test (IGTT), on insulin secretion in 10 otherwise healthy Caucasian men with recently diagnosed Type 2 diabetes (duration since diagnosis 0-44 months).
Insulin secretion (both overall and first phase) was significantly increased by nateglinide (P < 0.001), as were C-peptide (P < 0.001) and proinsulin (P < 0.001) secretion. Overall glucose concentrations following glucose challenge were lower after nateglinide than after placebo (P = 0.05).
Nateglinide significantly increases insulin secretion in Type 2 diabetic patients, in particular restoring the first phase insulin response. Further study is necessary to determine the effects of chronic administration on insulin secretion and blood glucose concentration.
新型非磺酰脲类口服降糖药那格列奈已被证实在动物和健康人类志愿者中可增强胰岛素分泌，因此在2型糖尿病的治疗方面有潜在进展。本研究探讨了那格列奈能否增强2型糖尿病患者的胰岛素分泌，尤其是第一时相胰岛素反应。
一项双盲、安慰剂对照试验，研究了在静脉葡萄糖耐量试验（IGTT）前20分钟单次口服60mg那格列奈对10名新近诊断为2型糖尿病（诊断后病程0 - 44个月）的健康白种男性胰岛素分泌的影响。
那格列奈显著增加了胰岛素分泌（总体及第一时相）（P < 0.001），C肽分泌（P < 0.001）和胰岛素原分泌（P < 0.001）也显著增加。葡萄糖激发后那格列奈组的总体血糖浓度低于安慰剂组（P = 0.05）。
那格列奈显著增加2型糖尿病患者的胰岛素分泌，尤其恢复了第一时相胰岛素反应。有必要进一步研究以确定长期给药对胰岛素分泌和血糖浓度的影响。
