中国临床药学杂志

目的 :观察格列吡嗪控释片治疗继发性磺脲类降糖药失效 2型糖尿病的疗效。方法 :选取继发性磺脲类降糖药失效的 2型糖尿病患者 6 4例 ,随机分为 2组 ,各 32例。治疗组予格列吡嗪控释片治疗 ,对照组予格列吡嗪速效片治疗 ,观察 8wk(治疗组分成 4wk剂量调整期 ,4wk维持期 )。治疗前后行 2次口服糖耐量试验 (OGTT)和胰岛素释放试验 ,计算胰岛素释放指数 (IRG)和胰岛素敏感指数 (ISI) ;比较 2组治疗前后血糖 ,血胰岛素 ,IRG ,ISI和临床疗效。结果 :与治疗前比较 ,治疗组治疗后血糖水平下降 ,ISI增高 ,P <0 .0 1;但胰岛素水平及IRG与服药前无显著性差异。对照组各指标治疗前后均无显著性差异。治疗组总有效率 (5 6 .2 % )显著高于对照组 (9.3% ) ,P <0 .0 1,且无明显不良反应发生。结论 :格列吡嗪控释片可改善继发性磺脲类降糖药失效的 2型糖尿病患者胰岛素敏感性及血糖控制 ,可作为继发性磺脲类降糖药失效患者的治疗药物

AIM: To observe the efficacy of glipizide GITS(gastrointestinal therapeutic system) in the treatment of secondary failure to sulfonylurea in noninsulin-dependent diabetes mellitus(NIDDM). METHODS: Sixty-four patients with secondary failure to sulfonylureas in NIDDM were allocated randomly and evenly into treatment group and control group. The patients in treatment group received glipizide GITS (32 cases). The patients in control group (32 cases) received immediate release glipizide. The patients of 2 groups received 8-week treatment (The treatment group was divided into two stages: 4-week dosage regulation period and 4-week dosage maintenance period). Oral glucose tolerance test (OGTT) and insulin releasing test were repeated before treatment and after treatment in 2 groups of NIDDM patients. Insulin reaction to glucose (IRG) and insulin sensitivity index (ISI) were calculated. The varieties of plasma glucose, plasma insulin, IRG, ISI and clinical effect of 2 groups were compared before treatment and after treatment. RESULTS: The patients in treatment group were improved in ISI and decreased in plasma glucose level after treatment as compared with before treatment(P<0.01),but IRG and plasma insulin weren't. There was no significant difference of plasma glucose, plasma insulin, ISI, IRG in the control group before treatment and after treatment. Furthermore, the treatment group gained even more excellent effect(56.2%) than the control group(9.3%) with no obvious adverse drug reaction. CONCLUSION: Glipizide GITS can improve insulin sensitivity and glycemic control in NIDDM patients with secondary failure to sulfonylureas. Glipizide GITS could have been used as a choice in the treatment of patients with secondary failure to sulfonylurea.