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目的:评估餐时血糖调节剂瑞格列奈(商品名:诺和龙)对老年2型糖尿病(T2DM)患者胰岛β细胞早时相分泌功能的影响及其用药安全性观察。方法:符合入选的患者,完成临床和实验室检查,根据血糖水平及胰岛素释放结果给予单独瑞格列奈口服治疗12周。结果:与基础值比较,瑞格列奈治疗12周后患者餐后2h血糖(2hPG)及糖化血红蛋白(HbA1c)水平均有显著下降,差异有显著性,P<0.05;空腹血糖(FBG)有所下降但差异无显著性,P>0.05。治疗前后比较,患者的空腹胰岛素(FINS)水平并无明显升高,P>0.05;Ins30、Ins60明显升高,P<0.05;而且Insl20、Insl80有下降趋势但差异无显著性,P>0.05。△I30/△G30比值明显升高,P<0.05,AUCINS未见明显变化,P>0.05。治疗前后比较患者的甘油三酯(TG)水平下降,P<0.05,总胆固醇(TC),低密度脂蛋白胆固醇(LDL-C)水平有所下降同时高密度脂蛋白胆固醇(HDL-C)水平略有上升,但差异无显著性P>0.05。治疗前后患者的收缩压(SBP)及舒张压(DBP)均未见明显变化,P>0.05。治疗过程中只有1例患者在早餐与午餐间出现轻微的低血糖的症状,当时测指尖血糖为3.3mmol/L,进食后症状缓解。应用瑞格列奈治疗后患者的肝肾功能均未见明显的异常,P>0.05。结论:瑞格列奈治疗可部分恢复老年T2DM早期时相胰岛素分泌,是一种有效的并且耐受性好的口服降糖药。
OBJECTIVE: To evaluate the effect of repaglinide, a normoglycemic modulator of blood glucose regulators, on the early phase-secretory function of pancreatic β cells in elderly patients with type 2 diabetes mellitus (T2DM) and the safety of its use. Methods: In line with the selected patients, complete clinical and laboratory tests, according to the blood glucose level and insulin release results were given alone repaglinide for 12 weeks. Results: The levels of 2hPG and HbA1c in post-prandial regimen were significantly decreased at 12 h after repaglinide treatment compared with the baseline values (P <0.05). The fasting blood glucose (FBG) The difference was not significant, P> 0.05. Before and after treatment, the level of fasting insulin (FINS) in patients had no significant increase, P> 0.05; Ins30, Ins60 increased significantly, P <0.05; and Insl20, Insl80 decreased but no significant difference, P> 0.05. △ I30 / △ G30 ratio was significantly increased, P <0.05, AUCINS no significant change, P> 0.05. The level of triglyceride (TG) in patients before and after treatment decreased (P <0.05), the level of total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) decreased and the level of high-density lipoprotein cholesterol Slightly increased, but the difference was not significant P> 0.05. Before and after treatment systolic blood pressure (SBP) and diastolic blood pressure (DBP) showed no significant change, P> 0.05. Only 1 patient had mild hypoglycemic symptoms between breakfast and lunch when the fingertip blood glucose was measured at 3.3 mmol / L and symptoms resolved after eating. The application of repaglinide in patients with liver and kidney function were no significant abnormalities, P> 0.05. Conclusion: Repaglinide treatment can partially restore the early phase insulin secretion in elderly patients with T2DM, which is an effective and well tolerated oral hypoglycemic agent.