De Marinis L, Barbarino A
Metabolism. 1980 Jul;29(7):599-604. doi: 10.1016/0026-0495(80)90103-1.
Intravenous infusion of verapamil, an organic antagonist of calcium transport into cells, produced a marked and significant inhibition of glucose-, glucagon- and sulfonylurea-induced increases in serum insulin in normal subjects. Also, blood glucose concentrations remained significantly higher after the secretagogue plus verapamil than after the secretagogue alone. Blood glucose concentrations increased regularly after verapamil + glucagon administration indicating that verapamil is not capable of inhibiting the hepatic glycogenolysis induced by glucagon. Two patients with islet-cell tumor, treated with verapamil for 5 days, experienced a decrease in the severity and frequency of hypoglycemic attacks while "autonomous" insulin release was inhibited. The present results clearly show that calcium antagonists are capable of inhibiting insulin response to appropriate stimuli in normal subjects. Therapeutic association of calcium antagonists and sulfonylureas should be used with caution in the light of the present findings. Calcium antagonists can be useful drugs in the treatment of hypoglycemia caused by islet-cell tumor.
静脉输注维拉帕米（一种阻止钙向细胞内转运的有机拮抗剂），可显著抑制正常受试者体内由葡萄糖、胰高血糖素和磺脲类药物诱导的血清胰岛素升高。此外，在给予促分泌剂加维拉帕米后，血糖浓度仍显著高于单独给予促分泌剂后。给予维拉帕米加胰高血糖素后，血糖浓度有规律地升高，这表明维拉帕米不能抑制胰高血糖素诱导的肝糖原分解。两名胰岛细胞瘤患者接受维拉帕米治疗5天，低血糖发作的严重程度和频率有所降低，同时“自主性”胰岛素释放受到抑制。目前的结果清楚地表明，钙拮抗剂能够抑制正常受试者对适当刺激的胰岛素反应。鉴于目前的研究结果，钙拮抗剂与磺脲类药物的联合治疗应谨慎使用。钙拮抗剂可能是治疗胰岛细胞瘤所致低血糖的有用药物。
