Sieradzki J
Katedra i Klinika Chorób Metabolicznych Uniwersytetu Jagiellońskiego w Krakowie.
Przegl Lek. 2000;57(1):5-8.
Etiopathogenesis of diabetes mellitus is bipolar. On one hand there occurs impairment in beta-cell function caused by genetic factors or abnormal development during fetal period. On the other hand defects of peripheral insulin action are also of significant importance. The bipolarity is also expressed by changing relationship between genetic and environmental factors. Insulin release is connected with closing ATP-dependent kalium channel, a structure closely connected with sulfonylurea receptors. Several receptors may be distinguished: SUR1 in Langerhans isles and SUR2 in heart (SUR2A) and vessel smoot muscles (SUR2B). In the treatment of insulin release disorders sulfonylureas are still of significant importance though repaglinid and phenyloalanine derivates also have some clinical importance. Within sulfonylurea derivates there have been developed some preparations of slow drug release (Glibenese GITS, Diaprel MR). One daily dose of Glibenese GITS and lower tendency to hypoglycaemia favour acceptation of the therapy by the patients what is also important for their quality of life. Quality of life is now regarded as important as obtaining good indices of diabetes control.
糖尿病的病因发病机制具有双相性。一方面，由于遗传因素或胎儿期发育异常导致β细胞功能受损。另一方面，外周胰岛素作用缺陷也具有重要意义。遗传因素与环境因素之间关系的变化也体现了这种双相性。胰岛素释放与关闭ATP依赖性钾通道有关，该结构与磺脲类受体紧密相连。可区分几种受体：胰岛中的SUR1以及心脏中的SUR2（SUR2A）和血管平滑肌中的SUR2B。在胰岛素释放障碍的治疗中，磺脲类药物仍然具有重要意义，尽管瑞格列奈和苯丙氨酸衍生物也具有一定临床意义。在磺脲类衍生物中，已开发出一些缓释制剂（格列本脲控释片、达美康缓释片）。格列本脲控释片每日一次给药且低血糖倾向较低，这有利于患者接受治疗，这对他们的生活质量也很重要。生活质量现在被认为与获得良好的糖尿病控制指标同样重要。
