Diabetes Division, Department of Medicine I, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany.
Profil, Neuss, Germany.
Diabetes Obes Metab. 2017 Nov;19(11):1625-1629. doi: 10.1111/dom.12968. Epub 2017 May 31.
It is known that β-cell function can be enhanced by direct stimulation of insulin secretion or by induction of β-cell rest, but whether both strategies can complement each other has not yet been examined. A total of 28 people with type 2 diabetes (glycated haemoglobin 7.8% ± 0.5%) were treated with either lixisenatide or titrated insulin glargine, followed by their combined administration, each over 4 weeks. First- and second-phase insulin secretion during an intravenous glucose challenge were calculated. First- and second-phase insulin secretion were not increased with glargine alone, but increased after addition of lixisenatide ( P < .001). Lixisenatide alone increased first- and second-phase insulin secretion ( P < .01). Addition of insulin glargine tended to further increase first-phase insulin secretion (P = .054), as well as insulin and C-peptide concentrations ( P < .05). Second-phase insulin secretion was not affected by the addition of glargine. The sequence of initiating lixisenatide or glargine had no effect on the final measures of glycaemia or insulin secretion. Thus, lixisenatide and, to a lesser extent, insulin glargine, increase glucose-stimulated insulin secretion in an additive manner.
已知β细胞功能可以通过直接刺激胰岛素分泌或诱导β细胞休息来增强，但这两种策略是否可以互补尚未得到检验。共有 28 名 2 型糖尿病患者（糖化血红蛋白 7.8%±0.5%）接受了利西那肽或甘精胰岛素滴定治疗，随后联合治疗，每种治疗持续 4 周。计算了静脉葡萄糖负荷试验期间的第一和第二相胰岛素分泌。甘精胰岛素单独使用不会增加第一和第二相胰岛素分泌，但添加利西那肽后会增加（P<0.001）。利西那肽单独使用可增加第一和第二相胰岛素分泌（P<0.01）。添加甘精胰岛素可能会进一步增加第一相胰岛素分泌（P=0.054），以及胰岛素和 C 肽浓度（P<0.05）。添加甘精胰岛素不会影响第二相胰岛素分泌。起始利西那肽或甘精胰岛素的顺序对最终血糖和胰岛素分泌测量没有影响。因此，利西那肽和在较小程度上的甘精胰岛素以附加方式增加葡萄糖刺激的胰岛素分泌。
