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泰萨格列净对 2 型糖尿病肥胖患者血糖控制和体重的影响(T-emerge 7 研究)。

Effects of taspoglutide on glycemic control and body weight in obese patients with type 2 diabetes (T-emerge 7 study).

机构信息

Endocrinology Center, Baylor Medical Center, Dallas, Texas, USA.

出版信息

Obesity (Silver Spring). 2013 Feb;21(2):238-47. doi: 10.1002/oby.20042.

Abstract

OBJECTIVE

Therapies that lower blood glucose and provide weight loss may provide meaningful benefits for obese patients with type 2 diabetes mellitus (T2DM). This study assessed the efficacy of taspoglutide compared with placebo on glycemic control and weight in obese patients with T2DM inadequately controlled with metformin monotherapy.

DESIGN AND METHODS

In a 24-week, randomized, double-blind, placebo-controlled, multicenter trial, obese adults with T2DM were randomized (1:1) to weekly subcutaneous taspoglutide 20 mg (10 mg for first 4 weeks) (n = 154) or placebo (n = 151) for 24 weeks. Efficacy measures included hemoglobin A1c (HbA1c) levels, body weight, percentage of patients achieving HbA1c ≤6.5 and ≤7.0%, and fasting plasma glucose (FPG). Adverse events (AEs) were assessed.

RESULTS

Mean baseline HbA1c was 7.55% and mean baseline BMI was 36.7 kg/m(2) . HbA1c reductions from baseline were significantly greater with taspoglutide than placebo (least square mean [LSMean], -0.81% vs. -0.09%; P < 0.0001). Weight loss at week 24 was significantly greater with taspoglutide than placebo (LSMean, -3.16 vs. -1.85 kg; P < 0.01). In the taspoglutide and placebo groups, target HbA1c levels (≤6.5%) were achieved by 49 and 16% of patients, respectively, while 72 and 36% achieved HbA1c levels ≤7%. Decreases in FPG were significantly greater with taspoglutide than placebo (-23.59 vs. 0.09 mg/dl; P < 0.0001). Nausea and vomiting were the most common AEs associated with taspoglutide, but tended to be transient and generally mild or moderate.

CONCLUSIONS

In obese patients with T2DM, once-weekly taspoglutide provided the combined benefits of glycemic control and weight loss.

摘要

目的

对于血糖控制不佳的肥胖 2 型糖尿病(T2DM)患者,降低血糖并减轻体重的治疗方法可能具有重要意义。本研究评估了每周皮下注射 20 毫克塔斯格鲁肽(前 4 周 10 毫克)与安慰剂相比,在二甲双胍单药治疗血糖控制不佳的肥胖 T2DM 患者中的疗效。

设计和方法

在一项为期 24 周的随机、双盲、安慰剂对照、多中心试验中,将 2 型糖尿病肥胖患者随机(1:1)分为每周皮下注射 20 毫克塔斯格鲁肽(前 4 周 10 毫克)(n=154)或安慰剂(n=151)组,共 24 周。疗效评估指标包括糖化血红蛋白(HbA1c)水平、体重、达到 HbA1c≤6.5%和≤7.0%的患者比例以及空腹血糖(FPG)。评估不良事件(AE)。

结果

平均基线 HbA1c 为 7.55%,平均基线 BMI 为 36.7kg/m2。与安慰剂相比,塔斯格鲁肽组的 HbA1c 降低幅度明显更大(最小二乘均值[LSMean],-0.81%比-0.09%;P<0.0001)。与安慰剂相比,塔斯格鲁肽组 24 周时体重下降更明显(LSMean,-3.16 比-1.85kg;P<0.01)。在塔斯格鲁肽和安慰剂组中,分别有 49%和 16%的患者达到了目标 HbA1c 水平(≤6.5%),而 72%和 36%的患者达到了 HbA1c 水平(≤7.0%)。与安慰剂相比,塔斯格鲁肽组的 FPG 降低更明显(-23.59 比 0.09mg/dl;P<0.0001)。与塔斯格鲁肽相关的最常见 AE 是恶心和呕吐,但通常为一过性,且一般为轻度或中度。

结论

在肥胖的 T2DM 患者中,每周一次的塔斯格鲁肽可同时实现血糖控制和体重减轻的效果。

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