Baker Heart and Diabetes Institute, Melbourne, Australia.
Eberhard Karls Universität Tübingen, Tübingen, Germany.
Diabetes Obes Metab. 2017 Dec;19(12):1793-1797. doi: 10.1111/dom.13022. Epub 2017 Jul 25.
The range of glycated haemoglobin (HbA1c) responses and characteristics associated with above-average response to exenatide twice daily and once weekly were examined. Data were pooled from 8 exenatide-twice-daily and 5 exenatide-once-weekly studies. A baseline HbA1c-corrected measure of change in HbA1c after 24 weeks identified high, average and low responses. Multiple linear regression and multivariate generalized estimating equation models identified factors associated with high response. Among 2355 participants (exenatide twice daily, n = 1414; exenatide once weekly, n = 941), baseline HbA1c correlated with change in HbA1c (P < .0001). Across baseline HbA1c levels, the 25th to 75th percentile of HbA1c change ranged from -0.3% to -3.2% with exenatide twice daily and from -0.5% to -3.6% with exenatide once weekly. Asian ethnicity and older age were significantly associated with high response to exenatide twice daily; no factors were significantly associated with response to exenatide once weekly. These data provide clinically useful information for estimating the likelihood that, depending on baseline HbA1c, an individual can achieve HbA1c goals. The association between Asian ethnicity, age and high response to exenatide twice daily may relate to the specific effects of exenatide twice daily on postprandial glucose.
检查了糖化血红蛋白(HbA1c)反应范围和与每日两次艾塞那肽和每周一次艾塞那肽反应高于平均水平相关的特征。从 8 项每日两次艾塞那肽和 5 项每周一次艾塞那肽研究中汇总了数据。在 24 周后,使用基线 HbA1c 校正的 HbA1c 变化衡量标准确定了高、中、低反应。多元线性回归和多变量广义估计方程模型确定了与高反应相关的因素。在 2355 名参与者(每日两次艾塞那肽,n = 1414;每周一次艾塞那肽,n = 941)中,基线 HbA1c 与 HbA1c 的变化相关(P <.0001)。在整个基线 HbA1c 水平范围内,每日两次艾塞那肽的 HbA1c 变化第 25 至 75 百分位数范围为 -0.3%至-3.2%,每周一次艾塞那肽的 HbA1c 变化第 25 至 75 百分位数范围为 -0.5%至-3.6%。亚洲种族和年龄较大与每日两次艾塞那肽的高反应显著相关;没有因素与每周一次艾塞那肽的反应显著相关。这些数据为根据基线 HbA1c 估计个体实现 HbA1c 目标的可能性提供了有临床意义的信息。亚洲种族、年龄与每日两次艾塞那肽高反应之间的关联可能与每日两次艾塞那肽对餐后血糖的特定作用有关。