2 ( Type 2 diabetes ) ( ) ( HbA1C ) ( Fasting blood glucose ) ( Postprandial blood glucose ) ( 95% ) 2 ( UKPDS )

Transcription

1 ( UKPDS ) ( 95% ) mg 1 ( HbA1C ) ( p<0.01 ) mg/dl.h 5.1 mg/dl.h ( p<0.05 ) ( 180 mg/dl H b A1C 8% ) H b A1C ( p<0.01 ) H b A1C ( Type diabetes ) ( HbA1C ) ( Fasting blood glucose ) ( Postprandial blood glucose ) 9 0 %

2 55 3 (The Diabetes Control and Complications Tr i a l ) ( United Kingdom Prospective Diabetes Study ) U K P D S 6 % m g / d l ( 500 mg ) 1 50 ( 1 ) ( 1 ) ( ) ( ( / ) 1 / 11 1 / 11 - p- v a l u e ( years ) ( years ) ( kgs ) ( kg/m ) FPG ( mg/dl) h PC ( mg/dl) H b A1C ( %) ( mmhg ) ( mmhg ) S u l f o n y l u r e a M e t f o r m i n S u l f o n y l u r e a M e t f o r m i n F P G h PC Student's t-test

3 56 ) 3 ( 1 11 ) ( body mass index ) SPSS 8.0 t - t e s t paired Student t-test ( Ganoderma tsugae ) t r i t e r- penoids nucleosid p o l y s a c c h a r i d e f i n g e r p r i n t ( Ganoderma lucidum ) 8 1 A m e t h o d s E D TA xg e n z y m a t i c 1 0 ( Meal Tolerance Test ) ( 30Kcal/kg/day ) ( 1 / 5 55 % 30 % 15% ) 1 3 B A B ( 180 mg/dl 180 mg/dl ) F P G H b A1C Glucose Area h PC B e f o r e A f t e r 1 B e f o r e A f t e r FPG ( mg/dl ) HbA1C ( % ) Glucose Area ( mg/dl.h ) h PC ( mg/dl ) F P G h PC H b A1C p p

4 ( A ) ( 180 mg/dl 180 mg/dl ) m g / d l 8.3 mg/dl p<0.05 ) F P G 180 m g / d l P C 50 mg/dl 50 mg/dl 900 mg/dl.h ( B ) mg/dl.h mg/dl.h p mg/dl. h ( , 5.1 mg/dl.h p<0.05 ) ( 180 mg/dl 180 mg/dl 50 mg/dl 50 m g / d l m g / d l. h 900 m g / d l. h H b A1C 8 % 8% ) ( ) F P G 180 mg/dl F P G ( , 7.7 H b A1C 8 % % p < % ( HbA1C 8 % 8% ) m g/d l mg/dl 3 F P G h PC Glucose Area H b A1C FPG ( mg/dl ) h PC ( mg/dl ) Glucose Area ( mg/dl.h ) ( % ) 8 % % F P G h PC Student's t-test p p

5 Monnier 1 7 "DECODE" ( 8 % 8% ) ( p 0.01 ) ( 1 3 ) m g / d l mg/dl.h m g / d l ( HbA1C 8% ) 8 % Type I error

6 59 1.Jervell J. Type II Diabetes (NIDDM) can be prevented. IDF Bulletin 1997; : 1-3..Tseng CH, Tseng CP, Chong CK, et al. Increasing incidence of diagnosed type diabetes in Taiwan: analysis of data from a national cohort. Diabetologia 006 9: Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Dellbanco TL. Unconventional medicine in the United States. N Engl J Med 1993; 38: 6-5..Matthews DR, Cull CA, Stratton IM, Holman RR, Turner RC. Sulphonylurea failure in non-insulin-dependent diabetic patients over six years.uk Prospective Diabetes Study (UKPDS) Group. Diabet Med 1998 ; 15: Garrow D, Egede LE. National patterns and correlates of complementary and alternative medicine use in adults with diabetes. J Altern Complement Med 006; 1: Bell RA, Suerken CK, Grzywacz JG, Lang W, Quandt SA, Arcury TA. Complementary and alternative medicine use among adults with diabetes in the United States. Altern Ther Health Med 006; 1: Min BS, Gao JJ, Nakamura N, and Hattori M. Triperpenes from the spores of Ganoderma lucidum and their cytotoxicity against Meth-A and LLC tumor cells. Chem Pharm Bull 000; 8: Shiao MS. Natural products of the medical fungus Ganoderma lucidum: occurrence, biological activities, and pharmacological functions. Chemical Record 003; 3: Zhabg HN, He JH, Yuan L, Lin ZB. In vitro and in vivo protective effect of Ganoderma lucidum polysaccharides on alloxaninduced pancreatic islets damage Life Sci 003; 73: Kadish AH, Litle RC, Sternberg JC. A new and rapid method for the determination of glucose by measurement of rate of oxygen consumption. Clin Chem 1968; 1: Hikino H, Ishiyama M, Suzuki Y, and Konno C. Mechanisms of hypoglycemic activity of ganoderan B: glycan of Ganoderma lucidum fruit bodies. Planta Med 1989; 55: Hikino H, Konno C, Mirin Y, Hayashi T. Isolation and hypoglycem ic ac tivity of Ganodera ns A a nd B, Glycans of Ganoderma lucidum fruit bodies1. Planta Med 1985; 51: Kino K, Mizumoto K, Sone T, et al. An immunomodulating protein, Ling Zhi-8 (LZ-8) prevents insulitis in non-obese diabetic mice. Diabetologia 1990; 33: Zhang HN, Lin ZB. Hypoglycemic effect of Ganoderma lucidum polysaccharides. Acta Pharmacol Sin 00; 5: Kimura Y, Okuda H, Aric hi S. Effects of the extracts of Ganoderma lucidum on blood glucose level in rats. Planta Med 1988; 5: Monnier L, Lapinski H, Colette C. Contributions of fasting and postprandial plasma glucose increments to the overall diurnal hyperglycemia of type diabetic patients: variations with increasing levels of HbA(1c). Diabetes Care 003; 6: Monnier L, Colette C, Dunseath GJ, Owens DR. The loss of postprandial glycemic control precedes stepwise deterioration of fasting with worsening diabetes. Diabetes Care 007; 30: Anonymous. Glucose tolerance and mortality: comparison of WHO and American Diabetes Association diagnostic criteria. The DECODE study group. European Diabetes Epidemiology Group. Diabetes epidemiology : collaborative analysis of diagnostic criteria in Europe. Lancet 1999; 35: Ceriello A, Davidson J, Hanefeld M, et al. International Prandial Glucose Regulation Study Group. Postprandial hyperglycaemia and cardiovascular complications of diabetes: an update. Nutr Metab Cardiovasc Dis 006; 16: Hanefeld M, Temelkova KT. The postprandial state and the risk of atherosclerosis. Diabetic Medicine 1997; 1: S6-11.

7 60 on Metabolic Control in Type Diabetes Subjects - -- A Double Blinded Placebo Control Study Chen-Wen Wang, Johannes Scheng-Ming Tschen, and Wayne Huey-Herng Sheu 1 Diabetes mellitus has become one of leading causes of death worldwide. Owing to progressive deterioration of current available hypoglycemic agents, Ganoderma lucidum, one of the most widely used herbs, was reported to lower blood glucose level in animal studies. We therefore undertook a clinical study to investigate the effect of Ganoderma lucidum on blood glucose control in subjects with type diabetes mellitus. We conducted a double-blind, placebo-controlled trial in which 6 patients completed the trial. Subjects were randomized to take dry extract of Ganoderma lucidum 3000 mg or placebo in addition to regular oral hypoglycemic agents for a period of 1 weeks. As a group, no differences were found in values of fasting glucose, HbA1c before versus after treatment both in placebo and Ganoderma lucidum groups. However, plasma glucose under the curve during meal tolerance test reduced more significantly in those of taking Ganoderma lucidum than those taking placebo (p 0.01, -way ANOVA). In those subjects with poor glycemic control (fasting glucose 180 mg/dl, A1c 8.0%), treatment by Ganoderma lucidum revealed a greater reduction in values of fasting glucose (p 0.05) and glucose area under cruve (p 0.01). Results of this study suggest that Ganoderma lucidum might play some role in providing postprandial glucose lowering as supplementary therapy in treating subjects with type diabetes mellitus. ( J Intern Med Taiwan 008; 19: 5-60 )