Division of Endocrinology and Metabolism, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
Diabetes Care. 2010 Jun;33(6):1294-6. doi: 10.2337/dc09-1959. Epub 2010 Mar 23.
Exenatide improves postprandial glycemic excursions in type 2 diabetes. Exenatide could benefit type 1 diabetes as well. We aimed to determine an effective and safe glucose-lowering adjuvant exenatide dose in adolescents with type 1 diabetes.
Eight subjects completed a three-part double-blinded randomized controlled study of premeal exenatide. Two doses of exenatide (1.25 and 2.5 microg) were compared with insulin monotherapy. Prandial insulin dose was reduced by 20%. Gastric emptying and hormones were analyzed for 300 min postmeal.
Treatment with both doses of exenatide versus insulin monotherapy significantly reduced glucose excursions over 300 min (P < 0.0001). Exenatide administration failed to suppress glucagon but delayed gastric emptying (P < 0.004).
Adjunctive exenatide therapy reduces postprandial hyperglycemia in adolescents with type 1 diabetes. This reduction in glucose excursion occurs despite reduction in insulin dose. We suggest that exenatide has therapeutic potential as adjunctive therapy in type 1 diabetes.
艾塞那肽可改善 2 型糖尿病患者餐后血糖波动。艾塞那肽可能对 1 型糖尿病也有益处。我们旨在确定 1 型糖尿病青少年患者有效且安全的辅助降血糖艾塞那肽剂量。
8 名受试者完成了餐前艾塞那肽三部分双盲随机对照研究。比较了艾塞那肽（1.25 和 2.5 微克）的两种剂量与胰岛素单药治疗的效果。餐前胰岛素剂量减少 20%。分析餐后 300 分钟的胃排空和激素。
与胰岛素单药治疗相比，两种剂量的艾塞那肽治疗均显著降低了 300 分钟内的血糖波动（P < 0.0001）。艾塞那肽给药未能抑制胰高血糖素，但延迟了胃排空（P < 0.004）。
辅助艾塞那肽治疗可降低 1 型糖尿病青少年的餐后高血糖。尽管胰岛素剂量减少，但葡萄糖波动仍有所降低。我们认为，艾塞那肽作为 1 型糖尿病的辅助治疗具有治疗潜力。
