Melga P, Mansi C, Ciuchi E, Giusti R, Sciaba L, Prando R
Department of Endocrine and Metabolic Sciences, University of Genoa, Italy.
Diabetes Care. 1997 Jan;20(1):55-8. doi: 10.2337/diacare.20.1.55.
We evaluated the effect of chronic administration of levosulpiride, a prokinetic drug that is a selective antagonist for D2 dopamine receptors, on the glycemic control of IDDM subjects.
The study was performed on 40 long-standing IDDM subjects with clinical signs of autonomic neuropathy and delayed gastric emptying. Gastric emptying time and glycemic parameters (diurnal glycemic profile and HbA1c) were checked under double-blind conditions before and after the administration of levosulpiride at the dosage of 25 mg t.i.d. orally for 6 months, or placebo.
No significant differences were noted in the glycemic and HbA1c values before and after 6 months of placebo administration. In contrast, after 6 months of levosulpiride, glycemic control had improved (HbA1c 6.7 +/- 0.4 and 5.7 +/- 0.3%, P < 0.01; mean daily glycemia 10.9 +/- 0.8 and 8.8 +/- 0.4 mmol/l, P < 0.05, at the start and at the end of the study), while the dosage of injected insulin (0.65 +/- 0.02 IU.kg-1.day-1) and the number of severe hypoglycemic episodes remained unchanged. After 6 months of levosulpiride therapy, the time of gastric emptying was significantly reduced from 321 +/- 14 to 261 +/- 9 min (P < 0.001) and dyspeptic symptoms had improved.
Our results show the importance of gastric emptying in the maintenance of glycemic control and the usefulness of chronic administration of levosulpiride in diabetic subjects with gastroparesis.
我们评估了长期服用左旋舒必利（一种促动力药物，是D2多巴胺受体的选择性拮抗剂）对胰岛素依赖型糖尿病（IDDM）患者血糖控制的影响。
该研究针对40名患有自主神经病变和胃排空延迟临床症状的长期IDDM患者进行。在双盲条件下，于口服25毫克左旋舒必利每日三次、持续6个月或服用安慰剂之前及之后，检查胃排空时间和血糖参数（日间血糖曲线和糖化血红蛋白HbA1c）。
服用安慰剂6个月前后，血糖和HbA1c值无显著差异。相比之下，服用左旋舒必利6个月后，血糖控制得到改善（研究开始时和结束时，HbA1c分别为6.7±0.4%和5.7±0.3%，P<0.01；平均每日血糖分别为10.9±0.8和8.8±0.4毫摩尔/升，P<0.05），而注射胰岛素的剂量（0.65±0.02国际单位·千克-1·天-1）和严重低血糖发作次数保持不变。左旋舒必利治疗6个月后，胃排空时间从321±14分钟显著缩短至261±9分钟（P<0.001），消化不良症状有所改善。
我们的结果表明胃排空在维持血糖控制中的重要性，以及长期服用左旋舒必利对患有胃轻瘫的糖尿病患者的有效性。
