Department of Medicine, Lund University, Lund, Sweden.
Diabetes Care. 2010 Apr;33(4):730-2. doi: 10.2337/dc09-1867. Epub 2010 Jan 12.
To determine if the dipeptidyl peptidase-4 inhibitor vildagliptin more effectively inhibits glucagon levels than the sulfonylurea glimepiride during a meal.
Glucagon responses to a standard meal were measured at baseline and study end point (mean 1.8 years) in a trial evaluating add-on therapy to metformin with 50 mg vildagliptin b.i.d. compared with glimepiride up to 6 mg q.d. in type 2 diabetes (baseline A1C 7.3 +/- 0.6%).
A1C and prandial glucose area under the curve (AUC)(0-2 h) were reduced similarly in both groups, whereas prandial insulin AUC(0-2 h) increased to a greater extent by glimepiride. Prandial glucagon AUC(0-2 h) (baseline 66.6 +/- 2.3 pmol . h(-1) . l(-1)) decreased by 3.4 +/- 1.6 pmol . h(-1) . l(-1) by vildagliptin (n = 137) and increased by 3.8 +/- 1.7 pmol . h(-1) . l(-1) by glimepiride (n = 121). The between-group difference was 7.3 +/- 2.1 pmol . h(-1) . l(-1) (P < 0.001).
Vildagliptin therapy but not glimepiride improves postprandial alpha-cell function, which persists for at least 2 years.
在进餐时，确定二肽基肽酶-4 抑制剂维达列汀是否比磺酰脲类药物格列美脲更有效地抑制胰高血糖素水平。
在一项评估二甲双胍联合 50mg 维达列汀 bid 或格列美脲（最大剂量 6mg qd）治疗 2 型糖尿病的试验中，在基线和研究终点（平均 1.8 年）测量了标准餐引起的胰高血糖素反应。基线 A1C 为 7.3±0.6%。
两组的 A1C 和餐后血糖曲线下面积（AUC）（0-2h）均相似降低，而格列美脲使餐后胰岛素 AUC（0-2h）增加幅度更大。维达列汀（n=137）使餐后胰高血糖素 AUC（0-2h）（基线 66.6±2.3pmol. h(-1). l(-1)）降低 3.4±1.6pmol. h(-1). l(-1)，格列美脲（n=121）使餐后胰高血糖素 AUC（0-2h）增加 3.8±1.7pmol. h(-1). l(-1)。两组间差异为 7.3±2.1pmol. h(-1). l(-1)（P<0.001）。
维达列汀治疗而非格列美脲改善了餐后α细胞功能，这种改善至少持续 2 年。
