Adelaide Medical School and Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, South Australia, Australia.
Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Diabetes Obes Metab. 2019 May;21(5):1251-1254. doi: 10.1111/dom.13632. Epub 2019 Jan 30.
Metformin has been shown to modulate the cardiovascular response to intraduodenal glucose in patients with type 2 diabetes (T2DM), and may have the capacity to regulate postprandial blood pressure (BP), which is often inadequately compensated in T2DM, resulting in postprandial hypotension. In the present study, we evaluated the acute effects of metformin on the BP and heart rate (HR) responses to oral glucose in patients with T2DM. Ten diet-controlled T2DM patients were evaluated on two occasions in a double-blind, randomized, crossover design. Participants received either metformin 1 g or saline (control) intraduodenally 60 minutes before ingesting a 50 g glucose drink labelled with 150 mg C-acetate. BP, HR, plasma glucagon-like peptide-1 (GLP-1) and gastric emptying (breath test) were evaluated over 180 minutes. Systolic and diastolic BP decreased and HR increased after oral glucose (P < 0.001 for all) on both days. Metformin attenuated the fall in systolic BP (P < 0.001), increased plasma GLP-1 concentrations (P < 0.05) and slowed gastric emptying (P < 0.05) without significantly affecting diastolic BP or HR. In conclusion, metformin acutely attenuates the hypotensive response to oral glucose, associated with augmented GLP-1 secretion and delayed gastric emptying, effects potentially relevant to its favourable cardiovascular profile.
二甲双胍已被证明可调节 2 型糖尿病（T2DM）患者十二指肠内葡萄糖引起的心血管反应，并且可能具有调节餐后血压（BP）的能力，而 T2DM 患者的餐后血压往往得不到充分补偿，导致餐后低血压。在本研究中，我们评估了二甲双胍对 T2DM 患者口服葡萄糖后血压和心率（HR）反应的急性影响。在双盲、随机、交叉设计中，10 名饮食控制的 T2DM 患者在两次评估中接受了二甲双胍 1g 或生理盐水（对照）的十二指肠内给药，在摄入 50g 葡萄糖饮料前 60 分钟标记有 150mg13C-乙酸盐。在 180 分钟内评估了血压、心率、胰高血糖素样肽-1（GLP-1）和胃排空（呼吸试验）。在两天中，口服葡萄糖后收缩压和舒张压降低，心率升高（所有 P<0.001）。二甲双胍减弱了收缩压的下降（P<0.001），增加了血浆 GLP-1 浓度（P<0.05）并减缓了胃排空（P<0.05），而对舒张压或心率没有显著影响。总之，二甲双胍可急性减轻口服葡萄糖引起的低血压反应，与 GLP-1 分泌增加和胃排空延迟有关，这些作用可能与其有利的心血管特征有关。
