Changes in prandial glucagon levels after a 2-year treatment with vildagliptin or glimepiride in patients with type 2 diabetes inadequately controlled with metformin monotherapy.
Changes in prandial glucagon levels after a 2-year treatment with vildagliptin or glimepiride in patients with type 2 diabetes inadequately controlled with metformin monotherapy.
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DOI：
10.2337/dc09-1867
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发表时间：
2010-04
期刊：
影响因子：
16.2
通讯作者：
Fonseca VA
中科院分区：
文献类型：
--
作者：
Ahrén B;Foley JE;Ferrannini E;Matthews DR;Zinman B;Dejager S;Fonseca VA
确定二肽基肽酶-4抑制剂维格鲁肽是否比磺酰脲类格列美脲更有效地抑制餐中胰高血糖素水平。在一项评价二甲双胍加用50 mg vildagelumab b.i.d.的试验中，在基线和研究终点（平均1.8年）测量了胰高血糖素对标准餐的反应。与高达6 mg q.d.的格列美脲相比，2型糖尿病（基线A1 C 7.3 ± 0.6%）。两组的糖化血红蛋白和餐时葡萄糖曲线下面积（AUC）0-2 h的降低程度相似，而格列美脲使餐时胰岛素AUC 0 -2 h的增加程度更大。餐后胰高血糖素AUC 0 -2 h（基线值66.6 ± 2.3 pmol · h−1 · l−1）在维格鲁肽（n = 137）的作用下降低3.4 ± 1.6 pmol · h−1 · l−1，在格列美脲（n = 121）的作用下升高3.8 ± 1.7 pmol · h−1 · l−1。组间差异为7.3 ± 2.1 pmol · h-1 · l-1（P < 0.001）。维达利治疗可改善餐后α-细胞功能，但不能改善格列美脲，这种作用可持续至少2年。
To determine if the dipeptidyl peptidase-4 inhibitor vildagliptin more effectively inhibits glucagon levels than the sulfonylurea glimepiride during a meal. Glucagon responses to a standard meal were measured at baseline and study end point (mean 1.8 years) in a trial evaluating add-on therapy to metformin with 50 mg vildagliptin b.i.d. compared with glimepiride up to 6 mg q.d. in type 2 diabetes (baseline A1C 7.3 ± 0.6%). A1C and prandial glucose area under the curve (AUC)0–2 h were reduced similarly in both groups, whereas prandial insulin AUC0–2 h increased to a greater extent by glimepiride. Prandial glucagon AUC0–2 h (baseline 66.6 ± 2.3 pmol · h−1 · l−1) decreased by 3.4 ± 1.6 pmol · h−1 · l−1 by vildagliptin (n = 137) and increased by 3.8 ± 1.7 pmol · h−1 · l−1 by glimepiride (n = 121). The between-group difference was 7.3 ± 2.1 pmol · h−1 · l−1 (P < 0.001). Vildagliptin therapy but not glimepiride improves postprandial α-cell function, which persists for at least 2 years.