Maurizi Anna Rita, Menduni Marika, Del Toro Rossella, Kyanvash Shadi, Maggi Daria, Guglielmi Chiara, Pantano Angelo Lauria, Defeudis Giuseppe, Fioriti Elvira, Manfrini Silvia, Pozzilli Paolo
Department of Endocrinology and Diabetes, University Campus Bio-Medico, Via Alvaro del Portillo 21, 00128, Rome, Italy.
Centre of Diabetes, Bart's and The London School of Medicine and Dentistry, Queen Mary's University of London, London, UK.
Acta Diabetol. 2017 Apr;54(4):361-365. doi: 10.1007/s00592-016-0954-x. Epub 2016 Dec 30.
To improve insulin sensitivity, insulin-sensitizing drugs such as metformin are commonly used in overweight and obese T1D patients. Similarly to metformin, D-chiro-inositol (DCI), as putative mediator of intracellular insulin action, can act as insulin sensitizer. The aim of this pilot study was to evaluate the hypothesis that DCI plus folic acid may improve glucose control reducing insulin resistance in overweight or obese T1D patients.
A 24-week randomized control trial was carried out in 26 overweight or obese T1D patients, undergoing intensive insulin therapy. Patients were randomized to 1 g DCI plus 400 mcg folic acid once daily (treated group) or to 400 mcg folic acid only once daily (control group). The primary end point was to evaluate the efficacy of DCI on metabolic control as assessed by HbA1c. As secondary endpoints, BMI and insulin requirement (IR) were evaluated. Paired t test (two tailed) and analysis of variance were used to evaluate differences in HbA1c, BMI and IR at different time points.
A significant reduction in HbA1c levels in treated group versus control group (7.5% ± 0.9 vs. 7.9% ± 1.7, respectively, p < 0.05) was observed. However, no significant reduction in BMI and IR was observed [(BMI 25.7 ± 2.8 vs. 26.7 ± 1.0, respectively, p NS); (IR 0.52 ± 0.26 vs. 0.52 ± 0.19, respectively, p NS)].
This trial demonstrated for the first time that DCI plus folic acid oral supplementation can improve metabolic control in overweight T1D patients. CLINICALTRIAL.
NCT02730949.
为提高胰岛素敏感性,二甲双胍等胰岛素增敏药物常用于超重和肥胖的1型糖尿病(T1D)患者。与二甲双胍类似,D-手性肌醇(DCI)作为细胞内胰岛素作用的假定介质,可充当胰岛素增敏剂。这项初步研究的目的是评估DCI加叶酸可能改善超重或肥胖T1D患者的血糖控制并降低胰岛素抵抗这一假设。
对26名接受强化胰岛素治疗的超重或肥胖T1D患者进行了一项为期24周的随机对照试验。患者被随机分为每日一次服用1克DCI加400微克叶酸(治疗组)或仅每日一次服用400微克叶酸(对照组)。主要终点是评估DCI对糖化血红蛋白(HbA1c)评估的代谢控制的疗效。作为次要终点,评估了体重指数(BMI)和胰岛素需求量(IR)。采用配对t检验(双侧)和方差分析来评估不同时间点HbA1c、BMI和IR的差异。
观察到治疗组的HbA1c水平较对照组显著降低(分别为7.5%±0.9与7.9%±1.7,p<0.05)。然而,未观察到BMI和IR有显著降低[(BMI分别为25.7±2.8与26.7±1.0,p无统计学意义);(IR分别为0.52±0.26与0.52±0.19,p无统计学意义)]。
该试验首次证明,口服补充DCI加叶酸可改善超重T1D患者的代谢控制。临床试验。
NCT02730949。