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利拉鲁肽附加治疗改善二甲双胍治疗的 2 型糖尿病患者的血糖控制。

Add-On Treatment with Liraglutide Improves Glycemic Control in Patients with Type 2 Diabetes on Metformin Therapy.

机构信息

1 Department of Health Sciences, University "Magna Græcia" of Catanzaro , Catanzaro, Italy .

2 Complex Operative Structure of Endocrinology-Diabetology, Pugliese-Ciaccio Hospital , Catanzaro, Italy .

出版信息

Diabetes Technol Ther. 2015 Jul;17(7):468-74. doi: 10.1089/dia.2014.0412. Epub 2015 Apr 6.

Abstract

BACKGROUND

Liraglutide is a glucagon-like peptide-1 receptor analog recently approved for the treatment of type 2 diabetes mellitus (T2DM). We aimed to assess the efficacy and safety of liraglutide versus glimepiride, as adjunct treatments to metformin, in achieving glycemic control in Italian patients with T2DM uncontrolled by metformin alone.

SUBJECTS AND METHODS

One hundred seventy-nine diabetes patients treated with metformin plus liraglutide (1.8 mg) or glimepiride (4 mg) were retrospectively assessed at baseline, during, and after 18 months of continuous therapy.

RESULTS

Treatment with liraglutide resulted in mean decreases in hemoglobin A1c (HbA1c) of -1.4%, when compared with glimepiride (-0.4%) (P < 0.001), and was followed by a significant reduction (P < 0.001) in fasting plasma glucose. Variations in HbA1c occurred independently from weight loss, which was significantly reduced (P < 0.001) in liraglutide-treated patients. The percentage of subjects reaching HbA1c levels below 7% or ≤ 6.5% was significantly different between the two treated groups (P < 0.001). Treatment with liraglutide reduced waist circumference (WC) (P < 0.001) and decreased both systolic and diastolic blood pressure (BP) (P < 0.001). It is interesting that the study also showed the impact of female gender in predicting a better glycemic response to liraglutide (P = 0.028).

CONCLUSIONS

Liraglutide was more effective than glimepiride in reducing HbA1c levels in treated patients with T2DM. This was evident in both genders, but particularly in women. Furthermore, liraglutide reduced body weight, WC, and BP, which are critical risk factors for cardiovascular disease.

摘要

背景

利拉鲁肽是一种胰高血糖素样肽-1 受体类似物,最近被批准用于治疗 2 型糖尿病(T2DM)。我们旨在评估利拉鲁肽与格列美脲相比,作为二甲双胍的辅助治疗,在控制单独使用二甲双胍无法控制的意大利 T2DM 患者血糖方面的疗效和安全性。

受试者和方法

179 例接受二甲双胍加用利拉鲁肽(1.8mg)或格列美脲(4mg)治疗的糖尿病患者在基线、治疗期间和 18 个月连续治疗后进行回顾性评估。

结果

与格列美脲(-0.4%)相比,利拉鲁肽治疗导致平均糖化血红蛋白(HbA1c)降低 1.4%(P<0.001),并随后显著降低空腹血糖(P<0.001)。HbA1c 的变化与体重减轻无关,而利拉鲁肽治疗组的体重明显减轻(P<0.001)。两组治疗后达到 HbA1c 水平<7%或≤6.5%的患者比例差异显著(P<0.001)。利拉鲁肽治疗降低了腰围(WC)(P<0.001),并降低了收缩压和舒张压(BP)(P<0.001)。有趣的是,该研究还表明,女性在预测利拉鲁肽更好的血糖反应方面具有更大的作用(P=0.028)。

结论

利拉鲁肽在降低 T2DM 治疗患者的 HbA1c 水平方面比格列美脲更有效。这在两性中均有体现,但在女性中更为明显。此外,利拉鲁肽降低了体重、WC 和 BP,这些都是心血管疾病的关键危险因素。

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