Jeng C Y, Hollenbeck C B, Wu M S, Chen Y D, Reaven G M
Department of Medicine, Stanford University School of Medicine, Palo Alto, California.
Diabet Med. 1989 May-Jun;6(4):303-8. doi: 10.1111/j.1464-5491.1989.tb01169.x.
Twelve patients with Type 2 diabetes and uncontrolled hyperglycaemia, never before treated with anti-diabetic drugs, were studied before and after several months of glibenclamide therapy. Fasting plasma glucose fell significantly (p less than 0.01) from 12.5 +/- 1.1 (mean +/- SE) to 8.3 +/- 0.4 mmol l-1 with glibenclamide therapy, as did glycosylated haemoglobin (from 12.0 +/- 0.9 to 8.4 +/- 0.7%). The improvement in blood glucose control was accompanied by an increase in postprandial plasma insulin concentration measured hourly from 0800 to 1600 h (p less than 0.001). Over the same period, plasma NEFA and lactate levels were significantly (p less than 0.001) lower after treatment with glibenclamide. Mean (+/- SE) insulin-mediated glucose metabolic clearance rate was evaluated during glucose clamp studies, and was significantly higher (p less than 0.001) after glibenclamide therapy at steady-state insulin levels of approximately 10 mU l-1 (53 +/- 3 vs 38 +/- 2 ml-2 min-1) and approximately 70 mU l-1 (78 +/- 9 vs 55 +/- 6 ml m-2 min-1). Hepatic glucose production was also lower following glibenclamide treatment at both the lower (56 +/- 5 vs 68 +/- 5 mg m-2 min-1) and higher 22 +/- 4 vs 32 +/- 6 mg m-2 min-1) insulin levels.(ABSTRACT TRUNCATED AT 250 WORDS)
对12例2型糖尿病且高血糖控制不佳、此前从未接受过抗糖尿病药物治疗的患者，在接受格列本脲治疗数月前后进行了研究。格列本脲治疗后，空腹血糖从12.5±1.1（均值±标准误）显著降至8.3±0.4 mmol/L（p<0.01），糖化血红蛋白也从12.0±0.9%降至8.4±0.7%（p<0.01）。血糖控制的改善伴随着从08:00至16:00每小时测量的餐后血浆胰岛素浓度升高（p<0.001）。同期，格列本脲治疗后血浆非酯化脂肪酸（NEFA）和乳酸水平显著降低（p<0.001）。在葡萄糖钳夹研究中评估了胰岛素介导的平均（±标准误）葡萄糖代谢清除率，在稳态胰岛素水平约为10 mU/L（53±3 vs 38±2 ml·m⁻²·min⁻¹）和约70 mU/L（78±9 vs 55±6 ml·m⁻²·min⁻¹）时，格列本脲治疗后该指标显著升高（p<0.001）。在较低（56±5 vs 68±5 mg·m⁻²·min⁻¹）和较高（22±4 vs 32±6 mg·m⁻²·min⁻¹）胰岛素水平下，格列本脲治疗后肝糖生成也较低。（摘要截选至250字）
