Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Inje University, Busan, South Korea.
Department of Pharmacology and Clinical Trial Centre, Inje University, Busan Paik Hospital, Busan, South Korea.
Can J Diabetes. 2015 Feb;39(1):24-8. doi: 10.1016/j.jcjd.2013.10.008. Epub 2014 Oct 8.
Gastrin increases the growth and neogenesis of the islets of Langerhans. Oral proton pump inhibitors (PPIs) increase the circulating gastrin level in animals and humans, but the therapeutic benefit of PPIs for diabetes mellitus has not been resolved. We examined whether treatment with a PPI for ≥2 months affected the glycated hemoglobin (A1C) level in patients with type 2 diabetes.
The electronic medical records of patients treated at the Busan Paik Hospital in South Korea were examined. The primary outcome measure was the change in A1C before and after PPI treatment for ≥2 months. We also tested if the primary outcome measure was affected by sex, age, duration of diabetes, body mass index, PPI molecule, duration of treatment with PPI or concurrent therapy with other antidiabetes agents.
In total, 43 patients (17 men and 26 women) were studied (mean age 63.8 years). Patients were treated with a PPI for a mean of 180 days. The A1C levels before and after treatment were not significantly different (6.86%±1.10% and 6.77%±1.07%, respectively; p=0.406). Metformin monotherapy did not lower A1C levels as compared with a combination therapy including metformin and antidiabetes medication not including metformin.
Proton pump inhibitor treatment of patients with type 2 diabetes did not reduce A1C levels. The data of this study were obtained from a retrospective chart review and included a small number of subjects. Furthermore, large randomized controlled studies are needed to define the effect of PPIs for type 2 patients with diabetes.
胃泌素可促进胰岛 Langerhans 细胞的生长和新生。口服质子泵抑制剂（PPIs）可增加动物和人体内的循环胃泌素水平，但 PPI 治疗糖尿病的疗效尚未明确。我们研究了接受 PPI 治疗≥2 个月是否会影响 2 型糖尿病患者的糖化血红蛋白（A1C）水平。
我们对韩国釜山 Paik 医院的患者电子病历进行了检查。主要观察指标为 PPI 治疗≥2 个月前后 A1C 的变化。我们还检验了主要观察指标是否受性别、年龄、糖尿病病程、体重指数、PPI 种类、PPI 治疗持续时间或其他降糖药物联合治疗的影响。
共纳入 43 例患者（男 17 例，女 26 例）（平均年龄 63.8 岁）。患者接受 PPI 治疗的平均时间为 180 天。治疗前后 A1C 水平无显著差异（分别为 6.86%±1.10%和 6.77%±1.07%；p=0.406）。与包含二甲双胍和不包含二甲双胍的其他降糖药物的联合治疗相比，二甲双胍单药治疗并不能降低 A1C 水平。
2 型糖尿病患者接受质子泵抑制剂治疗并未降低 A1C 水平。本研究的数据来自回顾性病历分析，且纳入的研究对象较少。此外，还需要开展大型随机对照研究以明确 PPI 对 2 型糖尿病患者的作用。
