Schultz T A, Lewis S B, Davis J L, Rost C R, Bliziotes M M
Am J Med. 1981 Feb;70(2):373-8. doi: 10.1016/0002-9343(81)90774-9.
It is well known that hemoglobin A1c reflects plasma glucose concentrations in patients with diabetes mellitus. To examine hemoglobin A1c and plasma glucose relationships in sulfonylurea-treated patients, 25 patients with well-controlled type II diabetes (fasting plasma glucose 128 +/- 6 mg/dl, hemoglobin A1c 7.6 +/- 0.5 percent) were evaluated in a double-blind study. This study was divided into two phases (periods I and II). During period I each patient was given a diet plus a placebo and was followed every two weeks until the mean of two consecutive plasma glucose determinations was more than 50 mg/dl above the initial plasma glucose concentration obtained while the patient was taking sulfonylurea. At that point each patient was switched in a double-blind fashion to either diet plus a placebo or diet plus tolazamide. Fasting plasma glucose concentrations increased to 178 +/- 9 mg/dl (p less than 0.005) for all patients by week 2 of period I. The increase in hemoglobin A1c concentration was seen to lag behind the increasing fasting plasma glucose concentration by four to six weeks. Fasting plasma glucose and hemoglobin A1c concentrations returned to values indistinguishable from initial values in patients who were given tolazamide and who responded to it. A positive correlation was noted when the hemoglobin A1c concentration was compared with the fasting plasma glucose concentration measured four to six weeks previously.
众所周知，糖化血红蛋白（HbA1c）反映糖尿病患者的血浆葡萄糖浓度。为了研究磺脲类药物治疗患者的HbA1c与血浆葡萄糖之间的关系，在一项双盲研究中对25例血糖控制良好的II型糖尿病患者（空腹血浆葡萄糖128±6mg/dl，HbA1c 7.6±0.5%）进行了评估。本研究分为两个阶段（阶段I和阶段II）。在阶段I期间，每位患者接受饮食加安慰剂治疗，每两周随访一次，直到连续两次血浆葡萄糖测定的平均值比患者服用磺脲类药物时获得的初始血浆葡萄糖浓度高出50mg/dl以上。此时，每位患者以双盲方式改为饮食加安慰剂或饮食加甲苯磺丁脲。在阶段I的第2周时，所有患者的空腹血浆葡萄糖浓度升至178±9mg/dl（p<0.005）。HbA1c浓度的升高比空腹血浆葡萄糖浓度的升高滞后4至6周。给予甲苯磺丁脲且有反应的患者，其空腹血浆葡萄糖和HbA1c浓度恢复到与初始值无差异的值。当将HbA1c浓度与4至6周前测得的空腹血浆葡萄糖浓度进行比较时，发现呈正相关。
