Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Yamadaoka, Suita.
Shiraiwa Medical Clinic.
J Diabetes Investig. 2012 Dec 20;3(6):510-6. doi: 10.1111/j.2040-1124.2012.00223.x.
(J Diabetes Invest, doi: 10.1111/j.2040-1124.2012.00223.x, 2012) Aims/Introduction: We assessed the efficacy of liraglutide therapy in Japanese type 2 diabetic patients insufficiently controlled with basal-supported oral therapy (BOT).
We retrospectively analyzed the data of 37 patients who had postprandial hyperglycemia (≥10.0 mmol/L) with BOT (long-acting insulin plus glimepiride) with their insulin titrated enough to keep preprandial glycemia <7.2 mmol/L, and who had their treatment changed to liraglutide monotherapy, with the subsequent addition of glimepiride, when required. Those who achieved the glycemic target at all points (preprandial glycemia <7.2 mmol/L and postprandial glycemia <10.0 mmol/L) were regarded as responders and the efficacy of liraglutide therapy was assessed. We also explored the predictive clinical characteristics associated with its efficacy.
Daily doses of insulin and glimepiride with BOT were 14 ± 9 units and 1.5 ± 0.9 mg, respectively. After the change to liraglutide therapy, 37% of the patients appeared to be responders to the therapy, whereas 12% had their glycemic control rather deteriorated. Efficacy of liraglutide therapy was significantly associated with baseline insulin dosage and post-breakfast glycemia with BOT. The C-statistic of the model was calculated to be 0.90.
There were responders and non-responders to liraglutide therapy in Japanese BOT failures. It is likely that baseline insulin dosage and post-breakfast glycemia with BOT are clinically useful indicators for the efficacy of liraglutide therapy.
(J 糖尿病投资,doi:10.1111/j.2040-1124.2012.00223.x,2012 年)目的/介绍:我们评估了利拉鲁肽治疗在基础支持口服治疗(BOT)控制不佳的日本 2 型糖尿病患者中的疗效。
我们回顾性分析了 37 例患者的数据,这些患者在 BOT(长效胰岛素加格列美脲)治疗时餐后血糖(≥10.0mmol/L)升高,且他们的胰岛素剂量足以控制餐前血糖<7.2mmol/L,当需要时,将其治疗改为利拉鲁肽单药治疗,并随后添加格列美脲。那些在所有时间点都达到血糖目标的患者(餐前血糖<7.2mmol/L,餐后血糖<10.0mmol/L)被认为是应答者,并评估利拉鲁肽治疗的疗效。我们还探讨了与其疗效相关的预测临床特征。
BOT 时胰岛素和格列美脲的日剂量分别为 14±9 单位和 1.5±0.9 毫克。改为利拉鲁肽治疗后,37%的患者对治疗有反应,而 12%的患者血糖控制恶化。利拉鲁肽治疗的疗效与基线胰岛素剂量和 BOT 时早餐后血糖显著相关。该模型的 C 统计量计算为 0.90。
日本 BOT 失败患者对利拉鲁肽治疗有反应者和无反应者。基线胰岛素剂量和 BOT 时早餐后血糖可能是利拉鲁肽治疗疗效的临床有用指标。