一例比较西他列汀与二甲双胍疗效的糖皮质激素诱导的糖尿病病例。
A case of glucocorticoid-induced diabetes in which the efficacy between sitagliptin and metformin was compared.
作者信息
Ishibashi Chisaki, Yasuda Tetsuyuki, Matsuoka Taka-Aki, Hirai Koichi, Sakamoto Fumie, Kitamura Tetsuhiro, Kozawa Junji, Otsuki Michio, Funahashi Tohru, Imagawa Akihisa, Kaneto Hideaki, Shimomura Iichiro
机构信息
1Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan.
2Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577, Matsushima, Kurashiki-shi, Okayama, 701-0192 Japan.
出版信息
Diabetol Int. 2015 Mar 15;7(1):89-94. doi: 10.1007/s13340-015-0209-z. eCollection 2016 Mar.
To date, promising strategies for treating glucocorticoid (GC)-induced diabetes with antidiabetic drugs have not been established. We herein report the case of a woman with GC-induced diabetes in which we compared the efficacy of two kinds of orally administered antidiabetic drugs sitagliptin and metformin by continuous glucose monitoring (CGM) and meal-challenge test (MCT). As a result, CGM showed that daily fluctuation of blood glucose levels was reduced during administration of metformin but not during administration of sitagliptin. On the other hand, MCT showed that administration of metformin reduced plasma glucose levels accompanied by the decrease of plasma insulin levels and the increase of plasma glucagon levels, whereas administration of sitagliptin had little effects on these parameters. This case is the first report to compare the efficacy between sitagliptin and metformin in glucose homeostasis by CGM and MCT in a patient with GC-induced diabetes.
迄今为止，尚未确立使用抗糖尿病药物治疗糖皮质激素（GC）诱导的糖尿病的有效策略。我们在此报告一例GC诱导的糖尿病女性病例，通过连续血糖监测（CGM）和进餐挑战试验（MCT）比较了两种口服抗糖尿病药物西他列汀和二甲双胍的疗效。结果，CGM显示，服用二甲双胍期间血糖水平的每日波动减小，而服用西他列汀期间则未减小。另一方面，MCT显示，服用二甲双胍可降低血浆葡萄糖水平，同时伴有血浆胰岛素水平降低和血浆胰高血糖素水平升高，而服用西他列汀对这些参数几乎没有影响。该病例是首例通过CGM和MCT比较西他列汀和二甲双胍对GC诱导的糖尿病患者葡萄糖稳态疗效的报告。
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