Unger Primary Care, 14726 Ramona Ave, Suite 110, Chino, CA, 91710, USA,
Curr Diab Rep. 2013 Oct;13(5):663-8. doi: 10.1007/s11892-013-0404-x.
Clinicians and patients are rapidly adapting GLP-1 receptor agonists as efficacious and safe therapeutic options for managing type 2 diabetes (T2DM). GLP-1 receptor agonists stimulate insulin production and secretion from the pancreatic β cells in a glucose-dependent manner, improve gastric emptying, favor weight reduction, and reduce postabsorptive glucagon secretion from pancreatic α cells. GLP-1 receptor activity is impaired in patients with T2DM. GLP-1 secretion and subsequent physiologic actions in patients with type 1 diabetes (T1DM) is ill-defined. Some researchers have suggested that the use of GLP-1 receptor agonists in T1DM may reduce excessive postprandial glucagon secretion allowing patients to reduce their total daily dose of exogenous insulin. Hypoglycemia risk may also be minimized in T1DM as glucagon counter-regulation can be preserved to some degree via the glucose-dependent action of the GLP-1 receptor agonists. This paper will consider the physiologic and pharmacologic benefits of adding GLP-1 receptor agonists to therapeutic regimens of patients with T1DM.
临床医生和患者正在迅速将 GLP-1 受体激动剂作为治疗 2 型糖尿病（T2DM）的有效且安全的治疗选择。GLP-1 受体激动剂以葡萄糖依赖性方式刺激胰腺β细胞产生和分泌胰岛素，改善胃排空，有利于减轻体重，并减少胰腺α细胞餐后胰高血糖素的分泌。T2DM 患者的 GLP-1 受体活性受损。1 型糖尿病（T1DM）患者的 GLP-1 分泌和随后的生理作用尚不清楚。一些研究人员认为，在 T1DM 中使用 GLP-1 受体激动剂可能会减少餐后胰高血糖素分泌过多，从而使患者能够减少每日外源性胰岛素的总剂量。低血糖风险也可能在 T1DM 中最小化，因为通过 GLP-1 受体激动剂的葡萄糖依赖性作用可以在一定程度上保留胰高血糖素的代偿作用。本文将考虑在 T1DM 患者的治疗方案中添加 GLP-1 受体激动剂的生理和药理益处。
