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題名 | ACARBOSE使用於口服降糖藥物失效之第2型糖尿病患者--臨床評估=Clinical Assessment of Effect of Acarbose in Type 2 Diabetic Patients of Secondary Oral Hypoglycemic Agent Failure |
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作者 | 宋育民; 吳崇榮; 李文珍; | 書刊名 | 內科學誌 |
卷期 | 10:1 1999.02[民88.02] |
頁次 | 頁8-12 |
分類號 | 415.6681 |
關鍵詞 | 第2型糖尿病; 血糖; 胰島素; C-胜冴; Acarbose; Type 2 DM; Plasma glucose; Insulin; C-peptide; |
語文 | 中文(Chinese) |
中文摘要 | Acarbose 為一�`-glucosidase競爭性抑制劑,可以有效地減緩單醣在小腸壁的 吸收速率。 本研究測試了 38 位使用傳統之口服降糖藥物但血糖失控之第 2 型糖尿病患者 ,在加上服用 acarbose 三個月之前後,血糖及胰島素濃度之變化。結果發現:空腹及早餐 飯後二小時血漿糖平均值均在服用 acarbose 三個月後有明顯降低 (Mean ± SE,分別為: 195 ± 7mg/dL vs 172 ± 7mg/dL, p=0.024; 311 ± 12 mg/dL vs 246 ± 13 mg/dL, p=0.000); 早餐飯後二小時血清胰島素 (58.2 ± 6.9 u/mL vs 34.3 ± 4.2 u/mL, p=0.004) 及 C- 胜�� (C-peptide) 濃度 (7.1 ± 0.5 ng/mL vs 5.2 ± 0.3 ng/mL, p =0.003) 皆呈有意義下降。 醣化血色素值也由 7.5 ± 0.2% 稍微下降至 6.9 ± 0.2% (p=0.083,未達統計學上意義 )。副作用包括脹氣、排氣及腹瀉,均在可以忍受之範圍內, 並未造成生活上的不適。本研究之結論為:acarbose 之投予能有效的降低第 2 型糖尿病患 者空腹及食後二小時血漿糖值並可有意義地下降食後之血清胰島素濃度。 |
英文摘要 | Acarbose, an �`-glucosidase inhibitor, delays the absorption of glucose by the intestinal mucosal cells by competitively inhibiting the enzyme �` -glucosidase and has been reported to be effective in smoothing the postprandial plasma glucose excursion in diabetic patients. We investigated the effect of adding acarbose to type 2 diabetic patients with background sulphonylurea and/or metfomin treatment whose blood sugar was poorly controlled by these oral hypoglycemc agents. Thirty-eight type 2 diabetic patients with poor sugar control were recruited in this clinical study. The levels of fasting and post-prandial plasma glucose and post-prandial serum insulin and C-peptide were evaluated before and after the addition of acarbose to the oral hypoglycemic agents already in use. A significant improvement in fasting plasma glucose (Mean ±SE:195 ± 7 mg/dL vs 172 ± 7 mg/dL, p=0.024) and 2-hr post-prandial plasma glucose (311 ± 12 mg/dL vs 246 ± 13 mg/dL, p=0.000) was found. There were also significant lowering in the post-prandial serum insulin (58.2 ± 6.9 u u/ml vs 34.3 ± 4.2u u/ml, p=0.004) and C-peptide (7.1 ± 0.5 ng/ml vs 5.2 ± 0.3 ng/ml, p=0.003) levels. Hemoglobin A1c showed a trend of decrement, though not to a statistically significant level (7.5 ± 0.2% vs 6.9 ± 0.2%,p=0.083). The side effects of acarbose included bloating, flatulence, and diarrhea in a decreasing order. When occurred, these side effects were experienced within the first two weeks after the administration of acarbose. None of the symptoms was intolerable by the participants during the study period o f3 months. We conclude that the administration of acarbose to type 2 diabetic patients with poor response to background sulphonylurea and/or metformin treatment is effective in improving both fasting and post-prandial plasma glucose levels and also in smoothing the postprandial serum insulin and C-peptide concentrations. |
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