Kabadi U M, Birkenholz M R
Veterans Administration Medical Center, Des Moines, Iowa City.
Arch Intern Med. 1988 Aug;148(8):1745-9.
The influence of sulfonylurea drugs in enhancing the effect of endogenous insulin is well documented. Furthermore, combination therapy with sulfonylurea and insulin is effective in the treatment of type II diabetes mellitus. Therefore, to assess the efficacy of this type of combination therapy in type I diabetes, we conducted a double-blind clinical trial with tolazamide and insulin in 15 subjects with type I diabetes. The diagnosis of type I diabetes was confirmed by previous episodes of diabetic ketoacidosis and undetectable C-peptide levels in serum samples from blood drawn from patients two hours after breakfast. During the study protocol, placebo or tolazamide was randomly added to insulin and the combination therapy was continued for three months. In the placebo group, levels of fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) did not alter significantly at the end of the study period. However, in the tolazamide group, levels of FPG and HbA1c markedly improved after administration of tolazamide (FPG levels before therapy, 10.8 +/- 0.9 mmol/L [mean +/- SEM]; after therapy, 6.7 +/- 0.4 mmol/L; HbA1c levels before therapy, 10.9% +/- 0.6%; after therapy, 9.6% +/- 0.5%). Therefore, adjuvant therapy with tolazamide and insulin may be beneficial in achieving adequate metabolic control in type I diabetes mellitus.
磺酰脲类药物增强内源性胰岛素作用的影响已有充分记录。此外，磺酰脲类药物与胰岛素联合治疗对II型糖尿病有效。因此，为评估此类联合治疗对I型糖尿病的疗效，我们对15名I型糖尿病患者进行了一项使用甲苯磺丁酰胺和胰岛素的双盲临床试验。I型糖尿病的诊断通过先前的糖尿病酮症酸中毒发作以及早餐后两小时采集的患者血样血清中检测不到C肽水平得以证实。在研究方案期间，将安慰剂或甲苯磺丁酰胺随机添加到胰岛素中，并持续联合治疗三个月。在安慰剂组中，研究期末空腹血糖（FPG）和糖化血红蛋白（HbA1c）水平无显著变化。然而，在甲苯磺丁酰胺组中，给予甲苯磺丁酰胺后FPG和HbA1c水平显著改善（治疗前FPG水平为10.8±0.9 mmol/L[平均值±标准误]；治疗后为6.7±0.4 mmol/L；治疗前HbA1c水平为10.9%±0.6%；治疗后为9.6%±0.5%）。因此，甲苯磺丁酰胺与胰岛素的辅助治疗可能有助于实现I型糖尿病患者充分的代谢控制。
