Introduction
hypoglycemic drug, blood glucose, hypoglycemic, type 2 diabetes, T2DM
TYPE 2 DIABETES
Mulberry twig alkaloids (SZ-A) represent the first original natural hypoglycemic drug to be discovered in China. They are capable of effectively inhibiting α-glycosidase and thus exerting beneficial hypoglycemic effects. One multi-center, randomized, double-blinded, and parallel controlled trial showed that after 24 weeks of treatment with SZ-A, patient levels of glycosylated hemoglobin (HbA1c) decreased by 0.93% from baseline, and their rate of achieving the HbA1c target (HbA1c<7%) was 47.7%—which was equivalent to that of treatment with acarbose for reducing postprandial blood glucose (When oral hypoglycemic drugs fail to control blood glucose in patients with type 2 diabetes (T2DM), these patients typically begin using insulin (Metformin(Met) is the first-line drug for the treatment of T2DM and plays an anti-hyperglycemic role mainly by inhibiting liver glucose through AMPK-dependent or -independent pathways (Continuous glucose monitors (CGM) can measure glucose concentrations in the subcutaneous interstitial fluid 288 times per day using multiple glucose sensors, allowing them to provide continuous, complete,and reliable glucose measurements with good compliance. To our knowledge, no studies have investigated the effects of SZ-A on blood glucose fluctuations.Therefore, in this study, CGMs were used to comprehensively evaluate blood glucose changes in patients with T2DM who were treated with premixed insulin combined with SZ-A or Met, compared to other treated with premixed insulin alone. We also considered blood lipid parameters, to provide a basis for exploring the hypoglycemic characteristics of SZ-A and determining the most suitable patients population for this treatment.