Postprandial hyperglycemia and insulin secretion

虽然2型糖尿病是老年人的主要健康问题，但对老年人β细胞功能的改变知之甚少。本研究的目的是探讨餐后高血糖在老年人挑战后高血糖中胰岛素分泌功能障碍的作用。老年人慢性餐后高血糖可通过葡萄糖毒性机制导致胰岛素分泌功能障碍。使用治疗药物使餐后高血糖正常化可能导致葡萄糖毒性的下降和胰岛素分泌的改善。阿卡波糖是一种α -葡萄糖苷酶抑制剂，可减少碳水化合物吸收，改善餐后高血糖，但对胰岛素分泌或敏感性没有直接影响。老年挑战后高血糖患者将被随机双盲分配到阿卡波糖或安慰剂治疗组。如果符合条件，受试者将接受基线测试，包括：静脉葡萄糖耐量试验（IVGTT）评估胰岛素敏感性和葡萄糖斜坡钳评估胰岛素分泌。受试者将服用阿卡波糖或安慰剂，为期六周。在治疗期结束时，受试者将进行第二次IVGTT和斜坡钳。在基线和给药期结束时进行口服葡萄糖耐量试验和72小时连续血糖监测，以评估餐后高血糖的正常化程度。

Although type 2 diabetes is a major health problem in the older population, little is known about alterations in beta cell function specifically in older adults. The objective of this study in to investigate the role of postprandial hyperglycemia in insulin secretory dysfunction in older adults with postchallenge hyperglycemia. Chronic postprandial hyperglycemia in older adults may lead to insulin secretory dysfunction through the mechanism of glucose toxicity. Normalization of postprandial hyperglycemia with a therapeutic agent may lead to a decline in glucose toxicity and an improvement in insulin secretion. Acarbose, an alpha-glucosidase inhibitor, decreases carbohydrate absorption and improves postprandial hyperglycemia without having direct effects on insulin secretion or sensitivity. Older adults with postchallenge hyperglycemia will be assigned to treatment with acarbose or placebo in a randomized, double-blind manner. If eligible to participate, subjects will undergo baseline tests including: an intravenous glucose tolerance test (IVGTT) to assess insulin sensitivity and a glucose ramp clamp to assess insulin secretion. Subjects will take either acarbose or placebo for six weeks. At the end of the treatment period, subjects will have a second IVGTT and ramp clamp. Oral glucose tolerance testing and 72-hour continuous glucose monitoring will be performed at baseline and at completion of the dosing period to assess the degree of normalization of postprandial hyperglycemia.