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目的比较格列喹酮(GLQ)、格列齐特(GLC)和格列本脲(GLB)对T2DM患者早相胰岛素分泌及餐后血糖波动的影响。方法入选新诊断的T2DM患者45例(5例脱落),FPG 5.0～11.1mmol/L,2hPG 11.1～22.2mmol/L,随机分配到GLQ(16例)、GLC(13例)及GLB(11例)治疗组。治疗前后行葡萄糖耐量—胰岛素释放试验(OGTT-IRT)。结果 3组治疗后血清胰岛素分泌水平均有增加趋势。GLQ组治疗后OGTT 45、60、120min血清胰岛素分泌显著升高(OGTT 45min胰岛素由治疗前(26.5±13.4)mU/L升至(50.4±32.2)mU/L,P=0.0102;OGTT 60 min胰岛素由治疗前(33.6±16.3)mU/L升至(59.7±26.7)mU/L,P=0.0023;OGTT 120min胰岛素由治疗前(43.6±19.3)mU/L升至(58.9±22.7)mU/L,P=0.0485)。与GLC、GLB组相比,GLQ组胰岛素分泌高峰前移,峰值出现在OGTT 60min,而GLC、GLB组胰岛素分泌高峰出现在OGTT 120min。结论 GLQ通过促进早相胰岛素分泌,显著减少新诊断的T2DM患者餐后血糖升高幅度,从而控制餐后高血糖。
Objective To compare the effects of GLQ, GLG and GLB on early phase insulin secretion and postprandial blood glucose in T2DM patients. Methods Forty-five newly diagnosed T2DM patients (5 exfoliated), FPG 5.0 ~ 11.1mmol / L and 2hPG 11.1 ~ 22.2mmol / L were randomized into GLQ (16 cases), GLC )therapy group. Before and after treatment, glucose tolerance - insulin release test (OGTT-IRT). Results Serum insulin secretion increased after treatment in all three groups. Serum insulin levels increased significantly at 45, 60 and 120 minutes after OGTT treatment in GLQ group (50.4 ± 32.2 mU / L, P = 0.0102 at 45.5 and 13.2 mU / L, respectively; (P <0.01). The insulin level increased from (33.6 ± 16.3) mU / L to (59.7 ± 26.7) mU / L before treatment , P = 0.0485). Compared with GLC group and GLB group, insulin secretion in GLQ group peaked at 60 min after OGTT, and peaked at 120 min in GLC and GLB group. CONCLUSION GLQ controls postprandial hyperglycemia by promoting early phase insulin secretion and significantly reducing the postprandial rise in postprandial glucose levels in newly diagnosed T2DM patients.