Kong M F, King P, Macdonald I A, Stubbs T A, Perkins A C, Blackshaw P E, Moyses C, Tattersall R B
Department of Diabetes, University Hospital Nottingham, UK.
Diabetologia. 1997 Jan;40(1):82-8. doi: 10.1007/s001250050646.
Pramlintide, a human amylin analogue, reduces hyperglycaemia after meals in patients with insulin-dependent diabetes mellitus (IDDM). We investigated whether this was due to delayed gastric emptying. Eight men with uncomplicated IDDM were studied twice in a randomised, double-blind crossover design. Euglycaemia was maintained overnight by intravenous infusion of glucose and/or insulin and the following morning a 5-h infusion of pramlintide 25 micrograms/h or placebo was started at 08.00 hours. At 08.30 hours the patients injected their normal morning insulin dose subcutaneously and 30 min later ate a meal (600 kcal, 50% carbohydrate) of which the solid component was labelled with Technetium-99 m and the liquid with Indium-111 to quantify gastric emptying. Gamma-scintigraphic images were obtained every 20 min for the next 4 h. Insulin and glucose were infused as necessary to maintain blood glucose levels within 3 mmol/l of the pre-meal value. Compared to placebo, pramlintide significantly delayed emptying of both liquid (median lag time 69 vs 7.5 min) and solid (median lag time 150 vs 44.5 min) components of the meal. Pramlintide delayed gastric emptying so much that t50 values could not be calculated for solid or liquid. Amylin agonists such as pramlintide may, therefore, be of value in improving glycaemic control in IDDM by modifying gastric emptying.
普兰林肽是一种人胰淀素类似物，可降低胰岛素依赖型糖尿病（IDDM）患者的餐后高血糖。我们研究了这是否是由于胃排空延迟所致。对8名无并发症的IDDM男性患者采用随机、双盲交叉设计进行了两次研究。通过静脉输注葡萄糖和/或胰岛素维持过夜血糖正常，次日上午8点开始以25微克/小时的速度输注普兰林肽或安慰剂，持续5小时。8点30分时，患者皮下注射其正常的早晨胰岛素剂量，30分钟后进食一顿餐（600千卡，50%为碳水化合物），其中固体成分用99m锝标记，液体用111铟标记，以量化胃排空情况。在接下来的4小时内，每隔20分钟获取一次γ闪烁显像图像。根据需要输注胰岛素和葡萄糖，以将血糖水平维持在餐前值的3毫摩尔/升范围内。与安慰剂相比，普兰林肽显著延迟了餐中液体（中位延迟时间69分钟对7.5分钟）和固体（中位延迟时间150分钟对44.5分钟）成分的排空。普兰林肽使胃排空延迟得如此之多，以至于无法计算固体或液体的t50值。因此，像普兰林肽这样的胰淀素激动剂可能通过改变胃排空来改善IDDM患者的血糖控制。
