Spellman Craig W
Department of Internal Medicine, Texas Tech University Health Sciences Center, 701 W Fifth St, Odessa, TX 79763-4206, USA.
J Am Osteopath Assoc. 2012 Jan;112(1 Suppl 1):S7-15.
Two glucagon-like peptide-1 (GLP-1) receptor agonists are currently approved for use in patients with type 2 diabetes mellitus: exenatide and liraglutide. Both of these injectable agents improve glycemic control as monotherapy or as combination therapy with oral agents. Overall, GLP-1 receptor agonists provide additive effects in dual and triple therapy regimens. In a clinical trial, the use of liraglutide resulted in greater improvements in glycosylated hemoglobin and fasting plasma glucose levels compared to exenatide, although the effects of exenatide on postprandial plasma glucose levels were greater. Clinical trials have also demonstrated statistically significant weight reduction, small beneficial effects on blood pressure, and unchanged lipid profiles with GLP-1 receptor agonists. The author reviews clinical trial data on the use of GLP-1 receptor agonists for patients with type 2 diabetes mellitus, outlines potential contraindications of these agents, and discusses the role of GLP-1 receptor agonists in algorithms for the initiation and advancement of treatment.
目前有两种胰高血糖素样肽-1（GLP-1）受体激动剂被批准用于2型糖尿病患者：艾塞那肽和利拉鲁肽。这两种注射剂作为单一疗法或与口服药物联合使用时均可改善血糖控制。总体而言，GLP-1受体激动剂在双联和三联治疗方案中具有附加作用。在一项临床试验中，与艾塞那肽相比，使用利拉鲁肽导致糖化血红蛋白和空腹血糖水平有更大改善，尽管艾塞那肽对餐后血糖水平的影响更大。临床试验还表明，GLP-1受体激动剂可使体重显著减轻，对血压有轻微有益影响，且血脂谱无变化。作者回顾了关于GLP-1受体激动剂用于2型糖尿病患者的临床试验数据，概述了这些药物的潜在禁忌症，并讨论了GLP-1受体激动剂在治疗起始和推进方案中的作用。
