那格列奈与格列吡嗪对初诊2型糖尿病患者胰岛β细胞功能影响的比较

Comparison of the effects of Nateglinide and Glipizide on functions of beta cells of islet in incipient diabetic patients

目的研究那格列奈对初诊2型糖尿病患者血糖及胰岛β细胞功能的影响。方法初诊2型糖尿病患者40例,分为那格列奈组与格列吡嗪组,干预8周后分别测定治疗前后血浆葡萄糖和胰岛素水平及糖化血红蛋白(HbA1C),同步记录体质量指数(body mass index,BMI)。结果那格列奈治疗后各点血糖水平及HbA1C均较治疗前下降,空腹血糖及餐后2 h血糖的下降较治疗前有显著性差异(P<0.05);那格列奈组与格列吡嗪组间治疗后餐后2 h血糖有显著性差异(P<0.05)。那格列奈治疗后胰岛素释放试验示胰岛素分泌高峰出现于餐后60 min,较治疗前有显著性差异(P<0.05);较格列吡嗪组同点数值差异亦有显著性(P<0.05)。结论那格列奈在降低空腹血糖和糖化血红蛋白的同时,更好地降低餐后血糖,且促进胰岛素的早期分泌,有效改善胰岛β细胞的功能。

Objective To study the effects of Nateglinide on blood glucose and functions of beta cells of islet in incipient diabetic patients. Methods Forty incipient diabetic patients were divided into Nateglinide group and Glipizide group. Plasma glucose, insulin levels （0 min,30 rain,60 rain, 120 min, 180 rain）, glycosylated hemoglobin（ HbA1 C）and body mass index（BMI） were observed at the beginning and after eight weeks＇ treatment. Results （ 1 ） In Nateglinide group the levels of blood glucose and HbA1C after the treatment were lower than that before therapy. Fasting blood sugar（FBS） and 2-hour postprandial blood sugar （P2hBS） were also significantly lower than that of pre-therapy（ P 〈 0.05 ） ;P2hBS in Nateglinide group were distinctly lower than that in Glipizide group （ P 〈 0.05 ）. （2） In Nateglinide group insulin secretion peak after treatment was observed 60 minutes later after meal through insulin releasing test, which had significant difference compared with that of before therapy. Conclusion With Glipizide group, the data difference at the same point also had significance differences （ P 〈 0.05 ）. Conclusion Nateglinide not only can decrease FBS and HBA1C,but also preferably lower P2hBS level in plasma, promote early insulin secretion and improve functions of beta cell of islet.