Deol Herpreet, Lekkakou Leoni, Viswanath Ananth K, Pappachan Joseph M
Department of Endocrinology & Diabetes, New Cross Hospital, The Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, WV10 0QP, UK.
Endocrine. 2017 Jan;55(1):173-178. doi: 10.1007/s12020-016-1125-0. Epub 2016 Sep 30.
Diabesity-obesity resulting in diabetes-is a major health problem globally because of the obesity epidemic. Several anti-diabetic medications cause weight gain and may worsen obesity, and possibly diabeisty. Two recent small retrospective cohort studies showed weight loss and diabetes improvement with combination of glucagon-like peptide-1 (GLP-1) agonists and sodium-glucose co-transporter type-2 (SGLT-2) inhibitors in obese subjects. We assessed the effect of combination therapy with GLP-1 agonists and SGLT-2 inhibitors in the management of diabesity in a retrospective study at the Wolverhampton Diabetes Centre. Out of 79 patients on this combination regimen with other anti-diabetic medications, 37 cases who had follow up at 3-6 months were studied. Mean age and duration of follow up were 57.4 (+/-7.8) and 139 (+/-32.6) days, respectively. Twenty-two patients (59.5 %) were Asians. Statistically significant improvements in clinical parameters such as body weight reduction (3.07 kg), glycated haemoglobin (HbA1c) reduction (1.05 %), lower BMI (-1.13 kg/M) and insulin dose reduction (6.8 units) were observed (p < 0.05 for all) in patients on combination regimen. Linear regression analysis showed that baseline HbA1c and baseline insulin dose were independent predictors of HbA1c reduction and insulin dose reduction, respectively. Our results suggest that combination therapy with GLP-1 agonists and SGLT-2 inhibitors is a promising option for patients with diabesity.
糖尿病肥胖症（肥胖导致糖尿病）是全球主要的健康问题，因为肥胖症流行。几种抗糖尿病药物会导致体重增加，可能会加重肥胖，进而可能加重糖尿病肥胖症。最近两项小型回顾性队列研究表明，胰高血糖素样肽-1（GLP-1）激动剂与2型钠-葡萄糖共转运体（SGLT-2）抑制剂联合使用可使肥胖受试者体重减轻且糖尿病病情改善。我们在伍尔弗汉普顿糖尿病中心进行的一项回顾性研究中，评估了GLP-1激动剂与SGLT-2抑制剂联合治疗糖尿病肥胖症的效果。在79例接受这种联合治疗方案并同时使用其他抗糖尿病药物的患者中，对37例在3至6个月进行了随访的患者进行了研究。平均年龄和随访时间分别为57.4（±7.8）岁和139（±32.6）天。22例患者（59.5%）为亚洲人。联合治疗方案的患者在体重减轻（3.07千克）、糖化血红蛋白（HbA1c）降低（1.05%）、体重指数降低（-1.13千克/米）和胰岛素剂量减少（6.8单位）等临床参数方面有统计学意义的显著改善（所有p值均<0.05）。线性回归分析表明，基线HbA1c和基线胰岛素剂量分别是HbA1c降低和胰岛素剂量减少的独立预测因素。我们的结果表明，GLP-1激动剂与SGLT-2抑制剂联合治疗对糖尿病肥胖症患者是一个有前景的选择。
