Bohannon N V, Karam J H, Lorenzi M, Gerich J E, Matin S B, Forsham P H
Diabetologia. 1977 Sep;13(5):503-8. doi: 10.1007/BF01234504.
In an attempt to elucidate the mechanism of action of phenformin, eleven juvenile-onset, insulin-requiring diabetic subjects underwent four different treatment regimens during standard breakfast tests. These four treatments were: control (no insulin or phenformin); insulin alone (15 U regular insulin administered subcutaneously one-half hour before breakfast); phenformin alone (50 mg of the timed-release capsule given twice daily for three days before the study and two and one-half hours before breakfast on the day of study); and phenformin plus insulin (in the amounts and at the times stated above). Phenformin was found to decrease postprandial hyperglycaemia significantly when compared with control values, and its addition to insulin further decreased the postprandial glucose rise below that found with insulin alone (p less than 0.005). These effects were associated with a reduction in early (30-min) postprandial hyperglucagonaemia (p less than 0.05). Triglyceride levels, gastrin secretion, growth hormone levels, and increments of alpha-amino nitrogen were not affected by phenformin. Thls, suppression of postprandial hyperglucagonaemia may be an additional mechanism in the reduction of postprandial hyperglycaemia after phenformin.
为了阐明苯乙双胍的作用机制，11名青少年起病、需要胰岛素治疗的糖尿病患者在标准早餐试验期间接受了四种不同的治疗方案。这四种治疗方法分别是：对照（不使用胰岛素或苯乙双胍）；单独使用胰岛素（早餐前半小时皮下注射15单位常规胰岛素）；单独使用苯乙双胍（在研究前三天每天两次服用50毫克缓释胶囊，研究当天早餐前两小时半服用）；以及苯乙双胍加胰岛素（剂量和时间如上所述）。与对照值相比，发现苯乙双胍可显著降低餐后高血糖，并且将其添加到胰岛素中可使餐后血糖升高进一步低于单独使用胰岛素时的水平（p<0.005）。这些作用与餐后早期（30分钟）高胰高血糖素血症的降低有关（p<0.05）。甘油三酯水平、胃泌素分泌、生长激素水平和α-氨基氮的增加不受苯乙双胍影响。因此，抑制餐后高胰高血糖素血症可能是苯乙双胍降低餐后高血糖的另一种机制。
