Klauser R, Speiser P, Gisinger C, Schernthaner G, Prager R
Department of Medicine II, University of Vienna, Austria.
J Cardiovasc Pharmacol. 1990;15 Suppl 1:S93-6.
Calcium antagonists have become widely used as antihypertensive treatment in diabetic patients, although data concerning a possible influence on glucose tolerance, insulin secretion, and platelet aggregation during long-term, placebo-controlled studies are lacking. Therefore, the effects of isradipine, a new calcium antagonist, on glucose tolerance and insulin secretion during a 75-g oral glucose tolerance test (OGTT) and on ADP- and collagen-induced maximum first-wave platelet aggregation (Tmax%) were studied in 11 type II diabetic patients with borderline hypertension. After a 2-week washout period, patients were treated with placebo or isradipine for 8 weeks in a double-blind, crossover study. Systolic blood pressure was lowered significantly after isradipine therapy compared to placebo (127 +/- 3 vs. 139 +/- 6 mm Hg; p less than 0.05). Fasting blood glucose (153 +/- 14 vs. 157 +/- 16 mg/dl; NS), glucose levels, and basal (17 +/- 4 vs. 17 +/- 2 mU/ml; NS) and stimulated insulin during the OGTT remained unchanged after either treatment. Platelet aggregation after stimulation with different concentrations of ADP and collagen showed no significant differences. These data indicate that calcium antagonists have no adverse effects on glucose tolerance, insulin secretion, and platelet aggregation in type II diabetes mellitus, and are therefore useful in the treatment of hypertension in diabetic patients.
钙拮抗剂已被广泛用作糖尿病患者的抗高血压治疗药物，尽管在长期、安慰剂对照研究中，关于其对葡萄糖耐量、胰岛素分泌和血小板聚集可能产生的影响的数据尚缺。因此，在11例患有临界高血压的II型糖尿病患者中，研究了新型钙拮抗剂伊拉地平在75克口服葡萄糖耐量试验（OGTT）期间对葡萄糖耐量和胰岛素分泌以及对ADP和胶原诱导的最大第一波血小板聚集（Tmax%）的影响。在为期2周的洗脱期后，患者在一项双盲交叉研究中接受安慰剂或伊拉地平治疗8周。与安慰剂相比，伊拉地平治疗后收缩压显著降低（127±3对139±6毫米汞柱；p<0.05）。两种治疗后，空腹血糖（153±14对157±16毫克/分升；无显著性差异）、葡萄糖水平以及OGTT期间的基础胰岛素（17±4对17±2毫单位/毫升；无显著性差异）和刺激后胰岛素均保持不变。用不同浓度的ADP和胶原刺激后血小板聚集无显著差异。这些数据表明，钙拮抗剂对II型糖尿病患者的葡萄糖耐量、胰岛素分泌和血小板聚集无不良影响，因此可用于糖尿病患者的高血压治疗。
