Dreval' A V, Cheporeva O N, Red'kin Iu A, Misnikova I V
Ter Arkh. 2010;82(8):41-4.
To analyze the effect of glibenclamide on carbohydrate metabolic parameters, glucose values after standard breakfast in particular, in patients with type 2 diabetes (T2D).
Thirty patients aged 57.6 +/- 9.4 years with a 4.4 +/- 4.0-year history of T2D received glibenclamide in a daily dose of 10.9 +/- 4.4 mg in combination with diet therapy for 3 months. Venous plasma glycemia was determined before and at the end of the fasting test, 60 and 120 minutes after a standard breakfast test. The area under the glycemic curve was calculated using the trapezoidal method during the standard breakfast test. Out of all possible formulas reflecting a blood glucose increase in relative values during the test, there were two most acceptable formulas that were chosen for further calculations: (1) the contribution of postprandial glycemia exceeding fasting glycemia to postprandial glycemia exceeding 6.1 mmol/l (OS(1/2)); (2) that of postprandial glycemia exceeding the glycemia of 6.1 mmol/l to postprandial glycemia in the standard breakfast test (OS2/S).
Follow 3-month therapy, glycated hemoglobin (HBA1c) decreased from 8.7 +/- 1.8 to 7.0 +/- 1.0% (p < 0.0001), fasting plasma glucose reduced from 9.8 +/- 2.7 to 8.3 +/- 1.7 mmol/l (p < 0.01); it decreased from 14.8 +/- 3.9 to 13.2 +/- 3.3 mmol/l (p < 0.01) and from 13.3 +/- 3.6 to 11.1 +/- 3.0 mmol/l (p < 0.02) 1 and 2 hours after the load test, respectively. There was a significant reduction in the total area under the glycemic curve (S)--from 1583.5 +/- 405.8 to 1375.7 +/- 320.1 mmol/l x rmin. However, there were no significant changes. There was a significant increase in the relative value OS(1/2) from 51.7 +/- 17.7 to 62.8 +/- 20.0% and a significant reduction in OS2/S. Analysis of the area in relative values (OS(1/2) and OS2/S) obviates the ambiguousness of the results obtained when analyzing the area in absolute values.
Glibenclamide treatment causes a statistically significant reduction in fasting and postprandial plasma glucose levels, glycated hemoglobin, and relative area values during the standard breakfast test.
分析格列本脲对2型糖尿病（T2D）患者碳水化合物代谢参数的影响，尤其是标准早餐后的血糖值。
30例年龄为57.6±9.4岁、T2D病程为4.4±4.0年的患者，接受每日剂量为10.9±4.4mg的格列本脲联合饮食治疗3个月。在空腹试验前及试验结束时、标准早餐试验后60分钟和120分钟测定静脉血浆血糖。在标准早餐试验期间采用梯形法计算血糖曲线下面积。在反映试验期间血糖相对值升高的所有可能公式中，选择了两个最可接受的公式进行进一步计算：（1）餐后血糖超过空腹血糖对餐后血糖超过6.1mmol/L的贡献（OS(1/2)）；（2）餐后血糖超过6.1mmol/L对标准早餐试验中餐后血糖的贡献（OS2/S）。
经过3个月治疗，糖化血红蛋白（HBA1c）从8.7±1.8%降至7.0±1.0%（p<0.0001），空腹血糖从9.8±2.7mmol/L降至8.3±1.7mmol/L（p<0.01）；负荷试验后1小时和2小时分别从14.8±3.9mmol/L降至13.2±3.3mmol/L（p<0.01）和从13.3±3.6mmol/L降至11.1±3.0mmol/L（p<0.02）。血糖曲线下总面积（S）显著降低——从1583.5±405.8降至1375.7±320.1mmol/L×分钟。然而，相对值OS(1/2)从51.7±17.7%显著增加至62.8±20.0%，OS2/S显著降低。对相对值面积（OS(1/2)和OS2/S）的分析消除了分析绝对值面积时所得结果的模糊性。
格列本脲治疗可使空腹和餐后血浆葡萄糖水平、糖化血红蛋白以及标准早餐试验期间的相对面积值在统计学上显著降低。
