Wajchenberg B L, Santomauro A T, Porrelli R N
Endocrine Secretion, Hospital das Clinicas, Sao Paulo, Brazil.
Diabetes Res Clin Pract. 1993 May;20(2):147-54. doi: 10.1016/0168-8227(93)90009-t.
Five male non-obese newly diagnosed NIDDM and 5 age-, sex- and body mass index (BMI) matched healthy controls without a family history of diabetes were submitted to a frequently sampled intravenous (i.v.) glucose tolerance test modified by exogenous insulin administration for estimation of insulin sensitivity (SI) and glucose-mediated glucose disposal (SG) with Bergman's minimal model computer analysis of glucose kinetics. The tests were repeated after 3 months treatment with a second generation sulfonylurea, gliclazide, in the diabetics subjects. SI and SG were markedly reduced before gliclazide therapy in the diabetics in comparison to the paired controls. After gliclazide, despite significantly lower (almost normal) plasma glucose, normalization of glycosylated hemoglobin and increased fasting insulin levels, there was a slight but significant increase in SI while SG showed a further reduction, the improvement in glucose control being also associated to the significant increased first and 2nd phase insulin release for the first 20 min after glucose infusion.
对5名新诊断出的非肥胖成年胰岛素依赖型糖尿病男性患者以及5名年龄、性别和体重指数（BMI）相匹配且无糖尿病家族史的健康对照者进行了一项频繁采样的静脉注射葡萄糖耐量试验，该试验通过外源性胰岛素给药进行了改良，以利用Bergman最小模型计算机分析葡萄糖动力学来评估胰岛素敏感性（SI）和葡萄糖介导的葡萄糖处置（SG）。糖尿病患者在接受第二代磺脲类药物格列齐特治疗3个月后重复进行了这些试验。与配对对照相比，糖尿病患者在接受格列齐特治疗前SI和SG显著降低。格列齐特治疗后，尽管血糖显著降低（几乎正常）、糖化血红蛋白正常化且空腹胰岛素水平升高，但SI略有但显著升高，而SG进一步降低，血糖控制的改善还与葡萄糖输注后最初20分钟内第一和第二阶段胰岛素释放的显著增加有关。
