瑞格列奈对初诊2型糖尿病患者血糖及第一时相胰岛素分泌的影响

The effects of repaglinide on blood glucose and the first-phase insulinsecretion in the newly diagnosed type 2 diabetes

目的探讨瑞格列奈的降糖作用及对2型糖尿病胰岛β细胞功能的影响。方法 35例初诊2型糖尿病患者服用瑞格列奈治疗16周,治疗前及停药后测空腹血糖(FPG)、糖化血红蛋白(HbA1c)、餐后2 h血糖(2 h PG),并于次日行静脉葡萄糖耐量-胰岛素释放试验(IVG-IRT),测定第一时相胰岛素分泌水平,计算基础胰岛素分泌功能指数(HOMA-β)、第一时相胰岛素曲线下面积(AUCINS0～10 min)、急性胰岛素反应(AIR)等。结果 35例初诊2型糖尿病患者,瑞格列奈治疗16周后,FPG、2 h PG、HbA1c均较基线显著降低(P<0.01),HOMA-β、AUCINS0～10 min及AIR均明显增加(均P<0.01)。结论瑞格列奈能明显改善初诊2型糖尿病患者的血糖及胰岛β细胞功能,急性胰岛素反应也可得到一定恢复。

Objective To investigate the effects of repaglinide on blood glucose and the function of β-cell in newly diagnosed type 2 diabetes.Methods 35 newly patients who diagnosed type 2 diabetes were orally taken repaglinide for 16 weeks.The fasting plasma glucose（FPG）,glycosylated hemoglobin（HbA1c）,2-hour postprandial blood glucose（2 h PG）were measured before and after the treatment,and the intravenous glucose tolerance test were taken on the next day,then insulin level of the first-phase insulin secretion was measured,basic insulin secretion index（HOMA-β）,the area under curve of first-phase insulin secretion（AUCINS0-10 min）and first-phase insulin secretion index（AIR0-10）were calculated respectively.Results After repaglinide treatment,for 16 weeks,FPG,2 h PG and HbA1c were all significantly decreased（P0.01）,and HOMA-β,AUCINS0-10 min and AIR0-10 were significantly increased.Conclusion Repaglinide therapy could significantly improve blood glucose,the function of β-cell and first-phase insulin secretion of the newly diagnosed type 2 diabetes.