Division of Endocrinology, Diabetes, and Metabolism, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX 75390, USA.
J Investig Med. 2013 Jan;61(1):40-4. doi: 10.2310/JIM.0b013e318279b7d6.
To observe the efficacy and safety of glucagonlike peptide-1 (GLP-1) analogs in type 1 diabetes in a real-life medical practice setting.
We performed a retrospective chart review of patients with type 1 diabetes initiated on a GLP-1 analog and with at least one follow-up visit at more than 4 weeks.
We identified 11 patients who were initiated on a GLP-1 analog and had a follow-up visit between 4 and 13 weeks (mean (SD) follow-up 10 ± 3 weeks; age 36.5 ± 16.4 years; duration of diabetes 17.3 ± 9.3 years; all on insulin pump therapy; all started on liraglutide). Seven of these patients had a second follow-up visit at approximately 20 weeks. By 10 weeks, there was a significant decrease in weight (4.2% of total body weight), total daily insulin dose (19.2%, of which 14.0% basal and 24.1% bolus), and mean (SD) insulin units/kg (0.57 [0.17] to 0.48 [0.17] units/kg). Hemoglobin A1c was significantly decreased (7.4 [0.7%] to 7.0 [0.7%], P = 0.02) without an increase in hypoglycemia. These effects were sustained at 20 weeks. Nausea was a common adverse effect and lead to drug discontinuation in 4 of 11 patients.
Patients with long-standing type 1 diabetes can achieve weight loss and improved glycemic control on less insulin without an increase in hypoglycemia when liraglutide is added to insulin therapy.
观察胰高血糖素样肽-1（GLP-1）类似物在真实医疗环境下治疗 1 型糖尿病的疗效和安全性。
我们对接受 GLP-1 类似物治疗且随访时间超过 4 周的 1 型糖尿病患者进行了回顾性病历审查。
我们共纳入 11 例接受 GLP-1 类似物治疗且随访时间在 4 至 13 周之间的患者（平均（SD）随访时间为 10 ± 3 周；年龄 36.5 ± 16.4 岁；糖尿病病程 17.3 ± 9.3 年；均接受胰岛素泵治疗；均起始用利拉鲁肽）。其中 7 例患者在大约 20 周时进行了第二次随访。10 周时，体重（占总体重的 4.2%）、每日总胰岛素剂量（19.2%，其中基础胰岛素减少 14.0%，餐时胰岛素增加 24.1%）和平均（SD）胰岛素用量/体重（0.57 [0.17]至 0.48 [0.17]单位/公斤）均显著下降。糖化血红蛋白显著降低（从 7.4 [0.7%]降至 7.0 [0.7%]，P=0.02），且低血糖无增加。这些效果在 20 周时仍保持稳定。恶心是一种常见的不良反应，导致 11 例患者中有 4 例停药。
在接受胰岛素治疗的基础上加用利拉鲁肽可使长期 1 型糖尿病患者体重减轻、血糖控制改善，同时胰岛素用量减少，低血糖风险无增加。
