Department of Endocrinology, Hvidovre University Hospital, and Department of Biomedical Sciences, the Panum Institute, University of Copenhagen, Copenhagen, Denmark.
Diabetes Care. 2011 Jul;34(7):1463-8. doi: 10.2337/dc11-0096. Epub 2011 May 18.
To investigate the effect of 4 weeks of treatment with liraglutide on insulin dose and glycemic control in type 1 diabetic patients with and without residual β-cell function.
Ten type 1 diabetic patients with residual β-cell function (C-peptide positive) and 19 without (C-peptide negative) were studied. All C-peptide-positive patients were treated with liraglutide plus insulin, whereas C-peptide-negative patients were randomly assigned to liraglutide plus insulin or insulin monotherapy. Continuous glucose monitoring with identical food intake and physical activity was performed before (week 0) and during (week 4) treatment. Differences in insulin dose; HbA1c; time spent with blood glucose<3.9, >10, and 3.9-9.9 mmol/L; and body weight were evaluated.
Insulin dose decreased from 0.50±0.06 to 0.31±0.08 units/kg per day (P<0.001) in C-peptide-positive patients and from 0.72±0.08 to 0.59±0.06 units/kg per day (P<0.01) in C-peptide-negative patients treated with liraglutide but did not change with insulin monotherapy. HbA1c decreased in both liraglutide-treated groups. The percent reduction in daily insulin dose was positively correlated with β-cell function at baseline, and two patients discontinued insulin treatment. In C-peptide-positive patients, time spent with blood glucose<3.9 mmol/L decreased from 3.0 to 1.0 h (P=0.03). A total of 18 of 19 patients treated with liraglutide lost weight during treatment (mean [range] -2.3±0.3 kg [-0.5 to -5.1]; P<0.001). Transient gastrointestinal adverse effects occurred in almost all patients treated with liraglutide.
Treatment with liraglutide in type 1 diabetic patients reduces insulin dose with improved or unaltered glycemic control.
研究利拉鲁肽治疗 4 周对有和无残余β细胞功能的 1 型糖尿病患者胰岛素剂量和血糖控制的影响。
研究了 10 例有残余β细胞功能（C 肽阳性）和 19 例无残余β细胞功能（C 肽阴性）的 1 型糖尿病患者。所有 C 肽阳性患者均接受利拉鲁肽联合胰岛素治疗，而 C 肽阴性患者则随机分为利拉鲁肽联合胰岛素或胰岛素单药治疗组。在治疗前（第 0 周）和治疗期间（第 4 周）进行相同的饮食摄入和体力活动的连续血糖监测。评估胰岛素剂量、HbA1c、血糖<3.9、>10 和 3.9-9.9mmol/L 的时间以及体重的差异。
C 肽阳性患者的胰岛素剂量从 0.50±0.06 降至 0.31±0.08 单位/千克/天（P<0.001），C 肽阴性患者的胰岛素剂量从 0.72±0.08 降至 0.59±0.06 单位/千克/天（P<0.01），而胰岛素单药治疗组的胰岛素剂量未发生变化。两组利拉鲁肽治疗患者的 HbA1c 均降低。每日胰岛素剂量的降低与基线时的β细胞功能呈正相关，有 2 例患者停止了胰岛素治疗。在 C 肽阳性患者中，血糖<3.9mmol/L 的时间从 3.0 小时降至 1.0 小时（P=0.03）。19 例接受利拉鲁肽治疗的患者中有 18 例在治疗期间体重减轻（平均[范围] -2.3±0.3kg[-0.5 至-5.1]；P<0.001）。几乎所有接受利拉鲁肽治疗的患者都出现了短暂的胃肠道不良反应。
在 1 型糖尿病患者中使用利拉鲁肽治疗可降低胰岛素剂量，同时改善或不改变血糖控制。
