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日本2型糖尿病患者早餐、午餐和晚餐耐量试验的血糖/代谢反应,以及米格列奈/伏格列波糖固定剂量联合用药对餐后血糖水平的影响

The glycemic/metabolic responses to meal tolerance tests at breakfast, lunch and dinner, and effects of the mitiglinide/voglibose fixed-dose combination on postprandial profiles in Japanese patients with type 2 diabetes mellitus.

作者信息

Ono Yuri, Nakamura Akinobu, Cho Kyu Yong, Nomoto Hiroshi

机构信息

Yuri Ono Clinic, Diabetes, Internal Medicine , Sapporo Kita-1 Ekimaedori Building 7F, 3-27, Nishi-3, Kita-1, Chuo-Ku, Sapporo 060-0001 , Japan +81 11 223 5152 ; +81 11 223 5153 ;

出版信息

Expert Opin Pharmacother. 2014 Feb;15(3):311-24. doi: 10.1517/14656566.2014.868437. Epub 2013 Dec 13.

Abstract

BACKGROUND

Meal tolerance tests (MTTs) are usually conducted at breakfast after overnight fasting in type 2 diabetes mellitus (T2DM) patients, but differences in postprandial glycemic responses between meals have been reported.

OBJECTIVE

We conducted MTTs at breakfast, lunch, and dinner to examine the effects of a fixed combination of 10 mg mitiglinide/0.2 mg voglibose (the combination) on glycemic/metabolic responses to meals during the day in T2DM patients. MTTs with unified meals were conducted in 11 T2DM patients before and after 4 weeks of treatment with the combination administered thrice daily before meals. Glycemic/metabolic profiles measured before and at 30, 60, and 120 min after each meal were compared between each meal and between the baseline and treatment periods.

RESULTS AND CONCLUSION

The combination significantly reduced postprandial hyperglycemia after each meal. Postprandial AUC0 - 120 min for insulin significantly decreased after lunch and dinner compared with after breakfast, while insulin levels significantly increased at only 30 min after breakfast and dinner. The combination also significantly increased postprandial C-peptide and active glucagon-like peptide-1 levels, and reduced free fatty acid and triglyceride levels, but did not significantly affect glucagon levels compared with baseline, confirming that treatment with the combination improves postprandial responses in Japanese T2DM patients.

摘要

背景

在2型糖尿病(T2DM)患者中,进餐耐量试验(MTT)通常在隔夜禁食后的早餐时进行,但已有报道称不同餐次的餐后血糖反应存在差异。

目的

我们在早餐、午餐和晚餐时进行MTT,以研究10 mg米格列奈/0.2 mg伏格列波糖固定复方制剂(复方制剂)对T2DM患者全天进餐时血糖/代谢反应的影响。在11例T2DM患者中,于每日三餐前服用复方制剂治疗4周前后,进行统一餐食的MTT。比较每餐前后以及基线期和治疗期餐后30、60和120分钟时测量的血糖/代谢指标。

结果与结论

复方制剂显著降低每餐餐后高血糖。午餐和晚餐后胰岛素餐后AUC0 - 120分钟较早餐后显著降低,而胰岛素水平仅在早餐和晚餐后30分钟显著升高。复方制剂还显著提高餐后C肽和活性胰高血糖素样肽-1水平,并降低游离脂肪酸和甘油三酯水平,但与基线相比对胰高血糖素水平无显著影响,证实该复方制剂治疗可改善日本T2DM患者的餐后反应。

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