Complementary glucagonostatic and insulinotropic effects of DPP-4 inhibitors in the glucose-lowering action of Japanese patients with type 2 diabetes
Complementary glucagonostatic and insulinotropic effects of DPP-4 inhibitors in the glucose-lowering action of Japanese patients with type 2 diabetes
复制标题
DPP-4 抑制剂在日本 2 型糖尿病患者降糖作用中的补充胰高血糖素和促胰岛素作用
DOI：
10.1007/s13340-015-0219-x
复制
发表时间：
2016
期刊：
影响因子：
2.2
通讯作者：
Takeda J
中科院分区：
文献类型：
--
作者：
Hashimoto K;Horikawa Y;Takeda J
作为单一疗法，二肽基肽酶-4(DPP-4)抑制剂引起低血糖的风险很低。然而，经常需要注射胰岛素，特别是在2型糖尿病和胰岛素分泌能力降低的患者。采用连续血糖监测(CGM)技术，对基础胰岛素不能完全控制的日本2型糖尿病患者加用DPP-4抑制剂的效果进行评估。观察加入DPP-4抑制剂对血糖、血浆胰岛素和胰高血糖素水平的影响。在胰岛素分泌能力减弱组中，Δ高血糖素与餐后血糖升高显著相关(P=0.016)，而在胰岛素分泌能力相对完整组中，ΔC肽与餐后血糖显著相关，≥为0.8(P=0.017)。在接受三种DPP-4抑制剂治疗的患者中，平均血糖水平和M值也有类似的改善。任何一组DPP-4抑制剂组均未发生低血糖。综上所述，根据日本2型糖尿病患者的胰岛素分泌能力，添加DPP-4抑制剂的降糖和促胰岛素作用是互补的。对于经常表现出胰岛素分泌能力降低的日本患者来说，这种联合疗法很可能是治疗糖尿病的一种更好的治疗选择。
The dipeptidyl peptidase-4 (DPP-4) inhibitors have a low risk of causing hypoglycemia as monotherapy. However, insulin administration is frequently required, particularly in patients with type 2 diabetes and with reduced insulin secretory capacity. The effects of adding DPP-4 inhibitors were evaluated using continuous glucose monitoring (CGM) in Japanese patients with type 2 diabetes who were insufficiently controlled by basal insulin with biguanide. The effects of adding DPP-4 inhibitors on blood glucose and plasma insulin and glucagon levels were evaluated. Δ glucagon showed a significant association with post-prandial glucose increase in the group with diminished insulin secretory capacity, C-peptide index(CPI) <0.8 (p= 0.016), while Δ C-peptide reached significant association in the group with relatively intact insulin secretory capacity, CPI ≥0.8 (p= 0.017). The mean plasma glucose levels andMvalues were similarly improved in patients treated with the three DPP-4 inhibitors. Hypoglycemia did not occur in any of the DPP-4 inhibitor groups. In conclusion, complementary glucagonostatic and insulinotropic effects of adding DPP-4 inhibitors are involved in the glucose-lowering action of Japanese patients with type 2 diabetes according to their insulin secretory capacity. Such combination therapy may well be a superior therapeutic option for the treatment of diabetes in Japanese patients who often exhibit reduced insulin secretory capacity.