Beck-Nielsen H, Hjøllund E, Pedersen O, Richelsen B, Sørensen N S
Diabetes Care. 1984 May-Jun;7 Suppl 1:100-5.
Sulfonylureas reduce plasma glucose concentrations in most patients with non-insulin-dependent diabetes mellitus (NIDDM). The mechanism of this action is controversial. In this article we examine the issue of the peripheral effect of these drugs, i.e., the effect on insulin receptors and insulin action. In our studies we have found that sulfonylureas possess a selective regulatory in vivo effect on the cellular insulin binding to monocytes, independent of the diet and changes in plasma glucose and insulin concentrations. Furthermore, we found in in vitro studies that sulfonylureas affect the insulin receptors in a direct way. Thus, insulin binding to monocytes was increased during sulfonylurea treatment in both normal volunteers and patients with NIDDM. On the other hand, sulfonylureas seem to improve insulin action in NIDDM patients only. We conclude that the increased insulin binding in patients with NIDDM, induced by sulfonylurea treatment, may be of importance for the improved insulin action found in these patients. However, this hypothesis has to be proved.
磺脲类药物可降低大多数非胰岛素依赖型糖尿病（NIDDM）患者的血糖浓度。其作用机制存在争议。在本文中，我们探讨了这些药物的外周效应问题，即对胰岛素受体和胰岛素作用的影响。在我们的研究中，我们发现磺脲类药物对细胞胰岛素与单核细胞的结合具有选择性的体内调节作用，这与饮食以及血糖和胰岛素浓度的变化无关。此外，我们在体外研究中发现磺脲类药物直接影响胰岛素受体。因此，在正常志愿者和NIDDM患者中，磺脲类药物治疗期间胰岛素与单核细胞的结合均增加。另一方面，磺脲类药物似乎仅能改善NIDDM患者的胰岛素作用。我们得出结论，磺脲类药物治疗诱导的NIDDM患者胰岛素结合增加，可能对这些患者胰岛素作用的改善具有重要意义。然而，这一假设有待证实。
