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在沙特阿拉伯初级保健诊所对2型糖尿病队列患者,在多种糖尿病治疗方案中加用利拉鲁肽对体重及低血糖风险的影响。

Effects of liraglutide addition to multiple diabetes regimens on weight and risk of hypoglycemia for a cohort with type 2 diabetes followed in primary care clinics in Saudi Arabia.

作者信息

Albarkah Yasser A, Tourkmani Ayla M, Bin Rsheed Abdulaziz M, Al Harbi Turki J, Ebeid Yasser A, Bushnag Reuof A

机构信息

Department of Pharmaceutical Care, Medical Services Directorate, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.

Family and Community Medicine, Chronic Diseases Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.

出版信息

J Family Med Prim Care. 2019 Jun;8(6):1919-1924. doi: 10.4103/jfmpc.jfmpc_372_19.

Abstract

CONTEXT

Available therapies for type 2 diabetes mellitus (T2DM) do not adequately control glycemia in the long term as they do not address the issue of declining beta cell function and do not impact positively on weight or cardiovascular concerns associated with the disease.

AIMS

To measure changes in hemoglobin A1c, weight, and hypoglycemia after the addition of liraglutide to 3 therapeutic regimens of patients with T2DM.

SETTINGS AND DESIGN

An observational cohort study that was implemented in Al-Wazarat Health Center in Riyadh, Saudi Arabia.

METHODS AND MATERIALS

The study included 38 T2DM patients who were screened for initiation of liraglutide in combination with their treatment regimens; sulphonylurea, sulphonylurea with basal insulin (glargine), and multiple daily injections of insulin. The cohort was followed for 12 months, and the liraglutide was started with 0.6 mg dose that escalated to 1.2 and 1.8 mg. Glycemic level and weight were measured 3 times, whereas hypoglycemia was measured 2 times.

STATISTICAL ANALYSIS USED

Quantitative continuous paired data were compared using a paired -test and the nonparametric Wilcoxon signed rank test.

RESULTS

There was a statistically significant reduction of hemoglobin A1c with 1.2 mg dose (mean difference = 0.84%, = 0.003). There were no statistically significant differences regarding the effect of liraglutide in addition to the 3 treatment regimens on patients' weight ( = 0.08, 0.472, 0.08, respectively). Regarding hypoglycemia, liraglutide has showed minimal effect.

CONCLUSIONS

Sustained effect of liraglutide on glycemic control in patients with T2DM without any major hypoglycemic episodes.

摘要

背景

2型糖尿病(T2DM)的现有疗法无法长期充分控制血糖,因为它们没有解决β细胞功能下降的问题,也没有对与该疾病相关的体重或心血管问题产生积极影响。

目的

在T2DM患者的3种治疗方案中添加利拉鲁肽后,测量糖化血红蛋白、体重和低血糖的变化。

设置与设计

在沙特阿拉伯利雅得的瓦扎拉特健康中心进行的一项观察性队列研究。

方法与材料

该研究纳入了38例T2DM患者,这些患者被筛选以开始将利拉鲁肽与他们的治疗方案联合使用;磺脲类药物、磺脲类药物联合基础胰岛素(甘精胰岛素)以及多次每日注射胰岛素。该队列随访12个月,利拉鲁肽起始剂量为0.6mg,逐渐增加至1.2mg和1.8mg。血糖水平和体重测量3次,而低血糖测量2次。

所用统计分析

定量连续配对数据使用配对t检验和非参数威尔科克森符号秩检验进行比较。

结果

1.2mg剂量的糖化血红蛋白有统计学显著降低(平均差异 = 0.84%,P = 0.003)。除3种治疗方案外,利拉鲁肽对患者体重的影响无统计学显著差异(P分别为0.08、0.472、0.08)。关于低血糖,利拉鲁肽显示出最小的影响。

结论

利拉鲁肽对T2DM患者的血糖控制有持续作用,且无任何严重低血糖事件。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11b9/6618200/7111aa80c19c/JFMPC-8-1919-g001.jpg

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