Tahrani Abd A, Piya Milan K, Barnett Anthony H
a Division of Medical Sciences, University of Birmingham and Department of Diabetes and Endocrinology, Birmingham Heartlands Hospital, Birmingham, UK.
b Division of Medical Sciences, University of Birmingham and Department of Diabetes and Endocrinology, Birmingham Heartlands Hospital, Birmingham, UK.
Expert Rev Endocrinol Metab. 2008 Nov;3(6):671-690. doi: 10.1586/17446651.3.6.671.
Exenatide is the first in a novel class of drugs that mimics naturally occurring glucagon-like peptide 1. In patients with Type 2 diabetes mellitus (T2DM), control of both glycemia and bodyweight are important to minimize the risk of diabetes complications. Exenatide improves glycemic control through glucose-dependent insulin secretion, suppression of glucagon secretion, delaying gastric emptying and suppressing appetite. Exenatide therapy significantly reduced glycated hemoglobin (Hb) and fasting and postprandial plasma glucose when added to metformin and/or sulfonylureas, with an average weight loss of 2 kg. Furthermore, exenatide-treated patients sustained the reductions achieved in Hb at 12 weeks with a progressive reduction in bodyweight during 3-year follow-up. Exenatide is generally well tolerated; nausea is the most common side effect but significantly reduces over time and with gradual dose titration. Hypoglycemia at a rate greater than placebo only occurred in combination with sulfonylureas. Exenatide may enable patients with T2DM to improve glycemic control while reducing the risk of hypoglycemia and provoking weight loss.
艾塞那肽是一类新型药物中的首个药物，这类药物可模拟天然存在的胰高血糖素样肽1。在2型糖尿病（T2DM）患者中，控制血糖和体重对于将糖尿病并发症风险降至最低至关重要。艾塞那肽通过葡萄糖依赖性胰岛素分泌、抑制胰高血糖素分泌、延缓胃排空和抑制食欲来改善血糖控制。当与二甲双胍和/或磺脲类药物联合使用时，艾塞那肽治疗可显著降低糖化血红蛋白（Hb）以及空腹和餐后血糖水平，平均体重减轻2千克。此外，接受艾塞那肽治疗的患者在12周时维持了Hb的降低水平，并且在3年随访期间体重逐渐减轻。艾塞那肽一般耐受性良好；恶心是最常见的副作用，但随着时间推移和逐渐增加剂量会显著减轻。仅在与磺脲类药物联合使用时，低血糖发生率才高于安慰剂。艾塞那肽可能使T2DM患者在降低低血糖风险并促进体重减轻的同时改善血糖控制。
