Kitabchi A E, Soria A G, Radparvar A, Lawson-Grant V
Am J Med Sci. 1987 Jul;294(1):10-4. doi: 10.1097/00000441-198707000-00002.
Insulin requirements, C-peptide levels, and serum lipids have been assessed in 12 obese, insulin-requiring (greater than 60 U/day) patients with type II diabetes mellitus, in a randomized crossover fashion with two treatment regimens: NPH alone and combined NPH and tolazamide, over a period of 3 months each, with maintenance of weight and glycemic control (HgA1, 2hpp and mean 24h glucose profile) at comparable levels. Serum cholesterol improved in both groups compared to their respective baseline values (p less than 0.05). In addition, serum triglyceride was lower (p less than 0.05) in the combined therapy as compared with NPH alone therapy. Insulin requirements were decreased by 23% (p less than 0.002) in the combined therapy group, without significant change in weight, glycemic control, or C-peptide levels. However, C-peptide increments in the combined therapy group were significantly higher than the baseline by 70% (p less than 0.02). NPH plus tolazamide therapy as compared with NPH alone lowers insulin requirement in obese, type II diabetic women without significant alteration in glycemic control, possibly by an increased tissue sensitivity to insulin, and decreases serum triglyceride levels.
对12名肥胖的、需要胰岛素治疗（每日用量大于60单位）的II型糖尿病患者，采用两种治疗方案以随机交叉方式进行了为期3个月的评估，这两种方案分别为单纯中性鱼精蛋白锌胰岛素（NPH）治疗和NPH联合甲苯磺丁脲治疗，期间维持体重和血糖控制（糖化血红蛋白、餐后2小时血糖及24小时平均血糖曲线）在相当水平。与各自的基线值相比，两组患者的血清胆固醇均有所改善（p<0.05）。此外，联合治疗组的血清甘油三酯水平低于单纯NPH治疗组（p<0.05）。联合治疗组的胰岛素需求量降低了23%（p<0.002），体重、血糖控制或C肽水平无显著变化。然而，联合治疗组的C肽增量比基线水平显著升高了70%（p<0.02）。与单纯NPH治疗相比，NPH加甲苯磺丁脲治疗可降低肥胖II型糖尿病女性的胰岛素需求量，且血糖控制无显著改变，这可能是由于组织对胰岛素的敏感性增加所致，同时还可降低血清甘油三酯水平。
