背景:2型糖尿病是一种常见的慢性疾病,在全球范围内患病率持续增加,是主要的医疗保健负担。糖尿病和高血压经常同时发生,降压药的使用在糖尿病患者中很常见。一种降压药,维拉帕米,在各种临床前模型中,初步显示出对血糖控制的潜在积极影响。
目的:评价维拉帕米对2型糖尿病高血压患者血糖控制的影响。
方法:从法哈德国王医疗城招募2型糖尿病高血压患者,利雅得,KSA,接受口服维拉帕米治疗。血压和糖代谢参数,包括空腹血糖(FPG),糖化血红蛋白(HbA1c),C-肽,和稳态模型评估胰岛素抵抗(HOMA-IR),在基线和维拉帕米治疗6个月后进行监测。
结果:35例患者(16例男性,招募了19名女性),平均年龄为57.2岁。使用维拉帕米与HbA1c无显著下降相关,FPG,C-肽,和HOMA-IR.然而,17名参与者的亚组显示HbA1c下降≥0.5%.单因素logistic回归显示,基线BMI,HOMA-IR,C肽与HbA1c降低≥0.5%显著相关(P<0.05)。
结论:维拉帕米是代谢中性的,可以稳定2型糖尿病患者的糖代谢参数。有必要进行其他研究,探索维拉帕米治疗可变反应背后的机制。
BACKGROUND: Type 2 diabetes is a common chronic disease that continues to increase in prevalence globally and is a major healthcare burden. Diabetes and hypertension frequently occur concurrently, and the use of antihypertensive agents is common in diabetic patients. One antihypertensive agent,
verapamil, has tentatively shown potentially positive effects on glycemic control in assorted pre-clinical models.
OBJECTIVE: To evaluate the effect of
verapamil on glycemic control in hypertensive type 2 diabetic patients.
METHODS: Type 2 diabetic hypertensive patients were recruited from King Fahad Medical City, Riyadh, KSA, to receive oral verapamil therapy. Blood pressure and glycometabolic parameters, including fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), C-peptide, and homeostatic model assessment insulin resistance (HOMA-IR), were monitored at baseline and after 6 months of verapamil therapy.
RESULTS: Thirty-five patients (16 male, 19 female) with a mean age of 57.2 years were recruited. The use of
verapamil was associated with non-significant decreases in HbA1c, FPG, C-peptide, and HOMA-IR. However, a sub-group of 17 participants showed a decrease in HbA1c that was ≥0.5%. Univariate logistic regression showed that baseline BMI, HOMA-IR, and C-peptide were significantly (P < 0.05) associated with HbA1c reductions of ≥0.5%.
CONCLUSIONS: Verapamil is metabolically neutral and allows the stabilization of glycometabolic parameters in type 2 diabetic individuals. Additional research exploring the mechanism behind the variable response to
verapamil therapy is warranted.