Department of Diabetes and Metabolic Medicine, Center Hospital, and Diabetes and Metabolism Information Center, Diabetes Research Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan,
Diabetes Ther. 2012 Nov;3(1):11. doi: 10.1007/s13300-012-0011-x. Epub 2012 Sep 28.
To examine the efficacy of sitagliptin and miglitol when added to ongoing insulin treatment in a patient with type 2 diabetes who had undergone partial gastrectomy.
Continuous glucose monitoring (CGM) was performed and either sitagliptin or miglitol, or both, were added to fixed-dose insulin therapy. Blood was drawn at 0, 30, 60, and 120 min after breakfast, and C-peptide, glucagon, glucagon-like peptide (GLP)-1, and glucose-dependent insulinotropic peptide (GIP) were measured.
CGM showed that compared to insulin alone, the addition of either sitagliptin or miglitol, or both, to insulin achieved better glucose control. Compared to insulin alone, early postprandial increments in plasma C-peptide levels and suppressed glucagon levels were observed when sitagliptin was added. Glucagon suppression was even more prominent when both sitagliptin and miglitol were added. Compared to insulin alone, GLP-1 levels were higher during the early postprandial stage when sitagliptin or miglitol was added and even higher when both were added. GIP levels decreased when sitagliptin or miglitol, or both, were added to insulin therapy.
The authors showed that the addition of sitagliptin or miglitol, or both, was effective in this insulin-treated patient with diabetes who had undergone gastrectomy.
研究在接受过部分胃切除术的 2 型糖尿病患者中，将西他列汀和米格列醇添加到正在进行的胰岛素治疗中是否有效。
进行连续血糖监测（CGM），并在固定剂量胰岛素治疗中添加西他列汀或米格列醇，或两者都添加。在早餐后 0、30、60 和 120 分钟抽取血液，并测量 C 肽、胰高血糖素、胰高血糖素样肽（GLP）-1 和葡萄糖依赖性胰岛素释放肽（GIP）。
CGM 显示，与单独使用胰岛素相比，添加西他列汀或米格列醇，或两者都添加到胰岛素中，可实现更好的血糖控制。与单独使用胰岛素相比，添加西他列汀时，血浆 C 肽水平的早期餐后增加和胰高血糖素水平的抑制更为明显。当同时添加西他列汀和米格列醇时，胰高血糖素的抑制作用更为明显。与单独使用胰岛素相比，添加西他列汀或米格列醇时，GLP-1 水平在早期餐后阶段更高，当两者都添加时更高。添加西他列汀或米格列醇，或两者都添加到胰岛素治疗时，GIP 水平下降。
作者表明，在接受过胃切除术的胰岛素治疗的糖尿病患者中，添加西他列汀或米格列醇，或两者都添加是有效的。
