Longnecker M P, Elsenhans V D, Leiman S M, Owen O E, Boden G
Arch Intern Med. 1986 Apr;146(4):673-6.
Using a double-blind crossover design, we studied the effect of tolazamide, an orally administered sulfonylurea, in 11 patients with non-insulin-dependent diabetes mellitus, poorly controlled on 40 units/day or more of insulin; all had previously failed to respond adequately to oral hypoglycemic agents and diet. In addition, six nondiabetic sex-, age-, and weight-matched controls were studied. Tolazamide significantly lowered fasting plasma glucose level from 272 +/- 21 to 222 +/- 31 mg/dL, increased fasting C peptide concentration from 0.09 +/- 0.03 to 0.28 +/- 0.10 pmole/mL (controls, 0.23 +/- 0.2 pmole/mL), and increased integrated C peptide concentration during a test meal (area under the curve) from 42 +/- 18 to 95 +/- 22 pmole/mL X min (controls, 94 +/- 8 pmole/mL X min). These data show that addition of tolazamide markedly increased fasting and meal-stimulated insulin secretion and modestly lowered fasting plasma glucose concentrations. We conclude that some patients who cannot achieve satisfactory control with oral hypoglycemic agents and diet may benefit from combined therapy with oral sulfonylurea agents plus insulin.
采用双盲交叉设计，我们研究了口服磺脲类药物妥拉磺脲对11例非胰岛素依赖型糖尿病患者的影响，这些患者每日使用40单位或更多胰岛素时血糖控制不佳；所有患者先前对口服降糖药和饮食均无充分反应。此外，还研究了6名年龄、性别和体重匹配的非糖尿病对照者。妥拉磺脲显著降低空腹血糖水平，从272±21mg/dL降至222±31mg/dL，使空腹C肽浓度从0.09±0.03pmole/mL增至0.28±0.10pmole/mL（对照者为0.23±0.2pmole/mL），并使试餐期间的C肽浓度积分（曲线下面积）从42±18pmole/mL·min增至95±22pmole/mL·min（对照者为94±8pmole/mL·min）。这些数据表明，加用妥拉磺脲可显著增加空腹及餐时刺激的胰岛素分泌，并适度降低空腹血糖浓度。我们得出结论，一些无法通过口服降糖药和饮食实现满意血糖控制的患者，可能从口服磺脲类药物加胰岛素的联合治疗中获益。
