Kishimoto Miyako, Noda Mitsuhiko
Department of Diabetes, Endocrinology, and Metabolism, Center Hospital, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan,
Clin Drug Investig. 2015 Feb;35(2):141-7. doi: 10.1007/s40261-014-0260-8.
The aim of this case study was to examine the efficacy of a dipeptidyl peptidase-4 inhibitor (anagliptin) and an α-glucosidase inhibitor (miglitol) when added to ongoing insulin treatment in patients with type 2 diabetes mellitus. Continuous glucose monitoring was performed in four Japanese insulin-treated inpatients with type 2 diabetes. Baseline data were collected on day 1. Miglitol was administered on days 2 and 3. On day 4, miglitol and anagliptin were coadministered before breakfast. On days 1, 3, and 5, blood was drawn for plasma glucose, serum C-peptide, plasma glucagon, total and active glucagon-like peptide-1 (GLP-1), and total and active glucose-dependent insulinotropic peptide (GIP) measurements. Coadministration of anagliptin with miglitol resulted in additional improvements in glycemic control over the entire day in three of the four patients. The C-peptide, glucagon, and total and active GLP-1 and GIP responded differently to the medications for each patient, suggesting interindividual differences in hormonal responses, which may be complicated by multifactorial effects.
本病例研究的目的是探讨在2型糖尿病患者中，将二肽基肽酶-4抑制剂（阿格列汀）和α-葡萄糖苷酶抑制剂（米格列醇）添加到正在进行的胰岛素治疗中时的疗效。对4名接受胰岛素治疗的日本2型糖尿病住院患者进行了连续血糖监测。在第1天收集基线数据。在第2天和第3天给予米格列醇。在第4天，早餐前同时给予米格列醇和阿格列汀。在第1、3和5天，采集血液用于测定血浆葡萄糖、血清C肽、血浆胰高血糖素、总活性胰高血糖素样肽-1（GLP-1）以及总活性葡萄糖依赖性促胰岛素多肽（GIP）。在4名患者中的3名患者中，阿格列汀与米格列醇联合给药导致全天血糖控制得到额外改善。C肽、胰高血糖素以及总活性GLP-1和GIP对每位患者所用药物的反应不同，表明激素反应存在个体差异，这可能因多因素影响而变得复杂。
