在二甲双胍单药治疗控制不佳的 2 型糖尿病患者中，经过 2 年的维格列汀或格列美脲治疗后，餐前胰高血糖素水平的变化。
Changes in prandial glucagon levels after a 2-year treatment with vildagliptin or glimepiride in patients with type 2 diabetes inadequately controlled with metformin monotherapy.
机构信息
Department of Medicine, Lund University, Lund, Sweden.
出版信息
Diabetes Care. 2010 Apr;33(4):730-2. doi: 10.2337/dc09-1867. Epub 2010 Jan 12.
OBJECTIVE
To determine if the dipeptidyl peptidase-4 inhibitor vildagliptin more effectively inhibits glucagon levels than the sulfonylurea glimepiride during a meal.
RESEARCH DESIGN AND METHODS
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%).
RESULTS
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).
CONCLUSIONS
Vildagliptin therapy but not glimepiride improves postprandial alpha-cell function, which persists for at least 2 years.
目的
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。
研究设计和方法
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%。
结果
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）。
结论
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。
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