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利拉鲁肽(一种胰高血糖素样肽-1类似物)对初治2型糖尿病患者进行血糖控制从而改善生活质量:PAGE1研究

Improvement of quality of life through glycemic control by liraglutide, a GLP-1 analog, in insulin-naive patients with type 2 diabetes mellitus: the PAGE1 study.

作者信息

Ishii Hitoshi, Niiya Tetsuji, Ono Yasuhiro, Inaba Naoyuki, Jinnouchi Hideaki, Watada Hirotaka

机构信息

Department of Diabetology, Nara Medical University, 840 Shijo-cho, Kashihara City, Nara, 634-8552 Japan.

Department of Internal Medicine, Matsuyama Shimin Hospital, Matsuyama, Ehime Japan.

出版信息

Diabetol Metab Syndr. 2017 Jan 7;9:3. doi: 10.1186/s13098-016-0202-0. eCollection 2017.

Abstract

BACKGROUND

In addition to achieving good glycemic control, diabetes care management aims to improve the quality of life (QOL) in patients. Treatment-associated difficulties and side effects frequently cause deterioration in QOL. Liraglutide, a GLP-1 receptor agonist, is a novel injection drug that promotes insulin secretion. It is a user-friendly, once-daily injection with fewer hypoglycemic events. In this study, we aimed to examine the effect of liraglutide therapy on QOL in patients.

METHODS

In total, 304 insulin- and liraglutide-naïve patients with type 2 diabetes were enrolled in this observational study; they received liraglutide therapy for 12 weeks. The main outcome measure was change in QOL from baseline, which was assessed using diabetes therapy-related QOL (DTR-QOL).

RESULTS

At week 12, liraglutide significantly decreased HbA1c levels (8.7 ± 1.5 vs. 7.5 ± 1.3,  < 0.001) and BMI (27.9 ± 5.3 vs. 27.3 ± 5.2,  < 0.001). According to the QOL scores, although the treatment modality had changed from non-injection to injection therapy, liraglutide improved patient satisfaction with treatment. Significant correlations were found between change in HbA1c level and satisfaction with treatment, as well as between change in body weight and burden on social and daily activities, anxiety and dissatisfaction with treatment, and hypoglycemia.

CONCLUSIONS

Liraglutide significantly improved glycemic control and reduced the body weight without deteriorating QOL in obese patients with type 2 diabetes. UMIN-CTR: UMIN000007159.

摘要

背景

糖尿病护理管理除了要实现良好的血糖控制外,还旨在提高患者的生活质量(QOL)。与治疗相关的困难和副作用常常导致生活质量下降。利拉鲁肽是一种胰高血糖素样肽-1(GLP-1)受体激动剂,是一种促进胰岛素分泌的新型注射药物。它使用方便,每日注射一次,低血糖事件较少。在本研究中,我们旨在探讨利拉鲁肽治疗对患者生活质量的影响。

方法

共有304例既往未使用过胰岛素和利拉鲁肽的2型糖尿病患者纳入本观察性研究;他们接受了12周的利拉鲁肽治疗。主要结局指标是生活质量相对于基线的变化,使用与糖尿病治疗相关的生活质量(DTR-QOL)进行评估。

结果

在第12周时,利拉鲁肽显著降低了糖化血红蛋白(HbA1c)水平(8.7±1.5 vs. 7.5±1.3,<0.001)和体重指数(BMI)(27.9±5.3 vs. 27.3±5.2,<0.001)。根据生活质量评分,尽管治疗方式从非注射治疗变为注射治疗,但利拉鲁肽提高了患者对治疗的满意度。糖化血红蛋白水平变化与治疗满意度之间,以及体重变化与社交和日常活动负担、焦虑、对治疗的不满以及低血糖之间均存在显著相关性。

结论

利拉鲁肽显著改善了2型糖尿病肥胖患者的血糖控制并减轻了体重,且未使生活质量恶化。日本大学医学信息网络临床试验注册编号:UMIN000007159。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d6c/5219656/3997735b26de/13098_2016_202_Fig1_HTML.jpg

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