Texas Diabetes Institute and Diabetes Division, University of Texas Health Science Center at San Antonio, San Antonio, Texas.
J Clin Endocrinol Metab. 2018 Apr 1;103(4):1402-1407. doi: 10.1210/jc.2017-01838.
To examine whether lowering plasma glucose concentration with the sodium-glucose transporter-2 inhibitor empagliflozin improves β-cell function in patients with type 2 diabetes mellitus (T2DM).
Patients with T2DM (N = 15) received empagliflozin (25 mg/d) for 2 weeks. β-Cell function was measured with a nine-step hyperglycemic clamp (each step, 40 mg/dL) before and at 48 hours and at 14 days after initiating empagliflozin.
Glucosuria was recorded on days 1 and 14 [mean ± standard error of the mean (SEM), 101 ± 10 g and 117 ± 11 g, respectively] after initiating empagliflozin, as were reductions in fasting plasma glucose levels (25 ± 6 mg/dL and 38 ± 8 mg/dL, respectively; both P < 0.05). After initiating empagliflozin and during the stepped hyperglycemic clamp, the incremental area under the plasma C-peptide concentration curve increased by 48% ± 12% at 48 hours and 61% ± 10% at 14 days (both P < 0.01); glucose infusion rate increased by 15% on day 3 and 16% on day 14, compared with baseline (both P < 0.05); and β-cell function, measured with the insulin secretion/insulin resistance index, increased by 73% ± 21% at 48 hours and 112% ± 20% at 14 days (both P < 0.01). β-cell glucose sensitivity during the hyperglycemic clamp was enhanced by 42% at 14 hours and 54% at 14 days after initiating empagliflozin (both P < 0.01).
Lowering the plasma glucose concentration with empagliflozin in patients with T2DM augmented β-cell glucose sensitivity and improved β-cell function.
研究钠-葡萄糖协同转运蛋白 2 抑制剂恩格列净是否能降低 2 型糖尿病（T2DM）患者的血浆葡萄糖浓度，从而改善β细胞功能。
15 例 T2DM 患者接受恩格列净（25mg/d）治疗 2 周。在开始恩格列净前、48 小时和 14 天后进行 9 步高血糖钳夹（每步 40mg/dL），以测量β细胞功能。
在开始恩格列净后的第 1 天和第 14 天，尿糖分别为[平均值±标准误（SEM），101±10g 和 117±11g]，空腹血糖水平分别降低了[25±6mg/dL 和 38±8mg/dL，均 P＜0.05]。在开始恩格列净后和进行逐步高血糖钳夹期间，血浆 C 肽浓度曲线下面积增量在 48 小时时增加了 48%±12%，在 14 天时增加了 61%±10%（均 P＜0.01）；葡萄糖输注率在第 3 天和第 14 天分别比基线增加了 15%和 16%（均 P＜0.05）；β细胞功能，以胰岛素分泌/胰岛素抵抗指数测量，在 48 小时时增加了 73%±21%，在 14 天时增加了 112%±20%（均 P＜0.01）。在开始恩格列净后 14 小时和 14 天时，高血糖钳夹期间β细胞的葡萄糖敏感性分别增强了 42%和 54%（均 P＜0.01）。
在 T2DM 患者中，通过恩格列净降低血浆葡萄糖浓度可增强β细胞的葡萄糖敏感性，并改善β细胞功能。
