Wang Wei-Qing, Zhang Yi-Fei, Zhou Da-Jin, Liu Zhi-Min, Hong Xu, Qiu Ming-Cai, Shi Yong-Quan, Xia Pei-Jin, Lu Jin, Xu Mao-Jing, An Liang, Feng Wei, Zhang Peng, Schwamman J, Ning Guang
Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Jiaotong University Medical School, Ruijin 2nd Road 197, Shanghai, 200025, P.R. China.
Endocrine. 2008 Feb;33(1):45-52. doi: 10.1007/s12020-008-9059-9. Epub 2008 Apr 10.
Since the increase of prevalence of type 2 diabetes mellitus (T-2DM), the replacing quickly absorbed carbohydrates with a fat source rich in monounsaturated fatty acid to provide improved glycemic control in these patients has become an important assistant therapy. In the present study, we compared glycemic response and safety of two nutritional products, Glucerna and Fresubin, in Chinese subjects with T-2DM. Overall, 203 T-2DM subjects were randomly assigned (1:1) to either Glucerna or Fresubin. The primary endpoint was the adjusted area under the curve (adj-AUC) for plasma glucose at 0-240 min. Blood samples were collected at 0, 30, 60, 90, 120, 180, and 240 min to compare the adjusted area under the curve (AUC) for the change in plasma glucose or insulin from 0 to 240 min. Adjusted peak values and times of glucose and insulin responses and adjusted glucose and insulin values were collected at the same time points. Safety parameters were also evaluated. The adjusted AUC for the change in plasma glucose in the Glucerna group was significantly lower than in Fresubin group (5.60 +/- 5.88 mmol/lh vs. 7.97 +/- 6.32 mmol/lh, P = 0.0061), as was the adjusted peak value of glucose (3.51 +/- 2.04 mmol/l vs. 4.69 +/- 1.99 mmol/l, P < 0.0001). Glucerna subjects had a longer adjusted peak time to insulin response compared to Fresubin subjects (105.00 +/- 43.4 min vs. 88.81 +/- 37.69 min, P = 0.0050). Glucerna subjects also experienced more gradual changes in glucose and insulin values. In conclusion, Glucerna provided better control of postprandial plasma glucose and insulin levels in Chinese subjects with T-2DM. Variation of postprandial glucose tended to be relatively stable after patients took Glucerna. Study results suggest that Glucerna may be beneficial in the reduction of postprandial glycemia.
随着2型糖尿病(T-2DM)患病率的上升,用富含单不饱和脂肪酸的脂肪源替代快速吸收的碳水化合物,以改善这些患者的血糖控制,已成为一种重要的辅助治疗方法。在本研究中,我们比较了两种营养产品——益力佳(Glucerna)和瑞素(Fresubin)对中国T-2DM患者的血糖反应和安全性。总体而言,203名T-2DM患者被随机(1:1)分配至益力佳组或瑞素组。主要终点是0至240分钟血浆葡萄糖的调整曲线下面积(adj-AUC)。在0、30、60、90、120、180和240分钟采集血样,以比较0至240分钟血浆葡萄糖或胰岛素变化的调整曲线下面积(AUC)。在相同时间点收集葡萄糖和胰岛素反应的调整峰值及时间,以及调整后的葡萄糖和胰岛素值。还评估了安全性参数。益力佳组血浆葡萄糖变化的调整AUC显著低于瑞素组(5.60±5.88 mmol/lh vs. 7.97±6.32 mmol/lh,P = 0.0061),葡萄糖的调整峰值也是如此(3.51±2.04 mmol/l vs. 4.69±1.99 mmol/l,P < 0.0001)。与瑞素组患者相比,益力佳组患者胰岛素反应的调整峰值时间更长(105.00±43.4分钟 vs. 88.81±37.69分钟,P = 0.0050)。益力佳组患者的葡萄糖和胰岛素值变化也更为平缓。总之,益力佳能更好地控制中国T-2DM患者的餐后血浆葡萄糖和胰岛素水平。患者服用益力佳后,餐后血糖变化趋于相对稳定。研究结果表明,益力佳可能有助于降低餐后血糖。