Will acarbose improve the metabolic abnormalities of insulin-resistant type 2 diabetes mellitus?
Will acarbose improve the metabolic abnormalities of insulin-resistant type 2 diabetes mellitus?
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DOI：
10.1016/s0168-8227(99)00009-1
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发表时间：
1999-03-01
影响因子：
5.1
通讯作者：
Welborn, T
中科院分区：
文献类型：
--
作者：
Scott, R;Lintott, CJ;Welborn, T
将105例仅接受饮食治疗的2型糖尿病患者（年龄36-71岁）随机分为阿卡波糖组（100 mg，每日3次）和安慰剂组（100 mg，每日3次），观察X综合征的临床和代谢指标变化。每周测量4次空腹血糖、糖化血红蛋白（HbA（1c））、真胰岛素、胰岛素原、纤维蛋白原和血脂水平，并在餐后0、1和2 h测定标准化1.6 MJ早餐对血糖、胰岛素、胰岛素原和甘油三酯的反应。分析基于意向治疗。在16周的治疗中，阿卡波糖降低了空腹血糖（P < 0.0001）、甘油三酯（P = 0.03）和HbA（1c）（P = 0.003）水平。从第0周至第16周，两组之间HbA（1c）的平均变化差异为0.4%（P=0.003）。胰岛素（P = 0.06）、胰岛素原（P = 0.07）和葡萄糖（P < 0.0001）对标准餐的反应降低。这些数据表明，阿卡波糖可降低空腹血糖和甘油三酯水平，降低HbA（1c），并限制伴有X综合征的2型糖尿病患者对食物的血糖和胰岛素反应。改善代谢环境和降低胰岛素抵抗的药物有可能限制与2型糖尿病相关的动脉粥样硬化的进展。(C)1999爱思唯尔科学爱尔兰有限公司保留所有权利。
Individuals with type 2 diabetes mellitus (n = 105; age 36-71 years) on diet therapy alone, and with quite good glycaemic control (mean HbA(1c) similar or equal to 7 0%) were randomized to receive acarbose (100 mg three times daily) or placebo for 16 weeks, and changes in clinical and metabolic parameters indicative of Syndrome X were monitored. Fasting levels of glucose, glycosylated haemoglobin (HbA(1c)), true insulin, proinsulin, fibrinogen and lipids were measured four times weekly, and glucose, insulin, proinsulin and triglyceride responses to a standardized 1.6 MJ breakfast were determined at 0, 1 and 2 h post meal. Analysis was on an intention-to-treat basis. Fasting levels of glucose (P < 0.0001), triglycerides (P = 0.03) and HbA(1c) (P = 0.003) were reduced by acarbose over the 16 weeks of treatment. The mean change in HbA(1c) from week 0 to 16 differed by 0.4% (P=0.003) between the two groups. Insulin (P = 0.06), proinsulin (P = 0.07) and glucose (P < 0.0001) responses to the standard meal were reduced. These data show that acarbose reduces fasting glucose and triglyceride levels, lowers HbA(1c) and limits the glycaemic and insulin response to food in individuals with type 2 diabetes mellitus with Syndrome X. Pharmacological agents that improve the metabolic environment and reduce insulin resistance have the potential to limit the progression of atherogenesis associated with type 2 diabetes mellitus. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.