Institute of Endocrinology and Metabolism, Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China.
Chin Med J (Engl). 2011 Jan;124(2):172-6.
Both repaglinide and gliclazide are insulin secretagogues widely used in the treatment of type 2 diabetes. They stimulate insulin secretion through distinct mechanisms and may benefit patients from different aspects. The present study was to evaluate the effects of repaglinide or gliclazide on glycaemic control, insulin secretion, and lipid profiles in type 2 diabetes patients.
A total of 47 newly diagnosed type 2 diabetes patients were randomized 1:1 to receive a 4-week treatment with repaglinide or gliclazide. The standard mixed meal tolerance test was performed before and after the treatment. Plasma glucose (PG), insulin concentration, and lipid profiles were measured. The area under insulin concentration curve (AUC(ins)) and the early-phase insulin secretion index (ΔI(30)/ΔG(30)) were calculated.
After the trial, fasting and postprandial PG and postprandial insulin improved significantly in both groups (P < 0.05). The maximum insulin concentration occurred earlier in the repaglinide group than that in the gliclazide group. AUC(ins) increased in both groups (P < 0.05), but no significant difference was found between groups. ΔI(30)/ΔG(30) increased in both groups (P < 0.05), especially in the repaglinide group (P < 0.05). Triglyceride and total cholesterol decreased significantly in the repaglinide group in some time points, while no significant change was observed in the gliclazide group.
Repaglinide and gliclazide had similar effects on glycaemic control and total insulin secretion, while repaglinide had more effects on improvements in β-cell function and lipid metabolism.
瑞格列奈和格列齐特均为广泛用于治疗 2 型糖尿病的胰岛素促分泌剂。它们通过不同的机制刺激胰岛素分泌，并可能从不同方面使患者受益。本研究旨在评估瑞格列奈和格列齐特对 2 型糖尿病患者血糖控制、胰岛素分泌和血脂谱的影响。
47 例新诊断的 2 型糖尿病患者按 1:1 随机分为瑞格列奈组或格列齐特组，分别接受为期 4 周的治疗。治疗前后进行标准混合餐耐量试验，测定血浆葡萄糖（PG）、胰岛素浓度和血脂谱。计算胰岛素浓度曲线下面积（AUC（ins））和早期胰岛素分泌指数（ΔI（30）/ΔG（30））。
试验后，两组患者空腹和餐后血糖及餐后胰岛素均明显改善（P < 0.05）。瑞格列奈组最大胰岛素浓度出现时间早于格列齐特组。两组 AUC（ins）均增加（P < 0.05），但两组间无显著差异。两组 ΔI（30）/ΔG（30）均增加（P < 0.05），尤其是瑞格列奈组（P < 0.05）。瑞格列奈组在某些时间点甘油三酯和总胆固醇显著降低，而格列齐特组无显著变化。
瑞格列奈和格列齐特在血糖控制和总胰岛素分泌方面具有相似的作用，而瑞格列奈在改善β细胞功能和脂代谢方面具有更大的作用。
