科研之友
微信
新浪微博
Facebook
分享链接
摘要
Context: The long-term effects of dipeptidyl peptidase-4 inhibitors on beta-cell function and insulin sensitivity in latent autoimmune diabetes in adults (LADA) are unclear. @@@ Objective: To investigate the effects of sitagliptin on beta-cell function and insulin sensitivity in LADA patients receiving insulin. @@@ Design and Setting: A randomized controlled trial at the Second Xiangya Hospital. @@@ Methods: Fifty-one patients with LADA were randomized to sitagliptin + insulin (SITA) group or insulin alone (CONT) group for 24 months. @@@ Main Outcome Measures: Fasting C-peptide (FCP), 2-hour postprandial C-peptide (2hCP) during mixed-meal tolerance test, Delta CP (2hCP - FCP), and updated homeostatic model assessment of beta-cell HOMA2-B) were determined every 6 months. In 12 subjects, hyperglycemic clamp and hyperinsulinemic euglycemic clamp (HEC) tests were further conducted at 12-month intervals. @@@ Results: During the 24-month follow-up, there were no significant changes in beta-cell function in the SITA group, whereas the levels of 2hCP and Delta CP in the CONT group were reduced at 24 months. Meanwhile, the changes in HOMA2-B from baseline were larger in the SITA group than in the CONT group. At 24 months, first-phase insulin secretion was improved in the SITA group by hyperglycemia clamp, which was higher than in the CONT group (P <.001), while glucose metabolized (M), insulin sensitivity index, and M over logarithmical insulin ratio in HEC were increased in the SITA group (all P <.01 vs baseline), which were higher than in the CONT group. @@@ Conclusion: Compared with insulin intervention alone, sitagliptin plus insulin treatment appeared to maintain beta-cell function and improve insulin sensitivity in LADA to some extent.
-
单位郑州大学; 1; 南方医科大学; 东莞市人民医院
