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在围手术期添加低剂量利拉鲁肽对胰岛素治疗的血糖控制是有用的:胰高血糖素样肽-1 受体激动剂治疗对接受心脏手术的患者血糖控制的影响(GLOLIA 研究)。

Addition of low-dose liraglutide to insulin therapy is useful for glycaemic control during the peri-operative period: effect of glucagon-like peptide-1 receptor agonist therapy on glycaemic control in patients undergoing cardiac surgery (GLOLIA study).

机构信息

Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan.

Department of, Data Science, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan.

出版信息

Diabet Med. 2019 Dec;36(12):1621-1628. doi: 10.1111/dme.14084. Epub 2019 Aug 2.

Abstract

AIM

To test the hypothesis that the addition of a glucagon-like peptide-1 receptor agonist that can decrease glucose levels without increasing the hypoglycaemia risk will achieve appropriate glycaemic control during the peri-operative period.

METHODS

We studied 70 people with Type 2 diabetes who underwent elective cardiac surgery. Participants were randomized to either an insulin-alone or an insulin plus liraglutide 0.6 mg/day group. We evaluated average M values, which indicated the proximity index of the target glucose level from day 1 to day 10.

RESULTS

The average M value in the liraglutide plus insulin group was significantly lower than that in the insulin-alone group (liraglutide plus insulin 5.8 vs insulin-alone 12.3; P < 0.001). The frequency of insulin dose modification in the liraglutide plus insulin group was significantly lower than that in the insulin-alone group (odds ratio 0.19, 95% CI 0.08-0.49; P < 0.001). The frequency of hypoglycaemia in the liraglutide plus insulin group tended to be lower than that in the insulin-alone group (odds ratio 0.57, 95% CI 0.15-2.23; P = 0.21).

CONCLUSIONS

The results of this study showed that the addition of low-dose liraglutide to insulin achieved lower M values than insulin alone, suggesting that the addition of low-dose liraglutide may achieve better glycaemic control during the peri-operative period. (Clinical trials registry no.: UMIN 000008003).

摘要

目的

检验这样一个假设,即添加一种可以降低血糖而不增加低血糖风险的胰高血糖素样肽-1 受体激动剂,将在围手术期实现适当的血糖控制。

方法

我们研究了 70 名接受择期心脏手术的 2 型糖尿病患者。参与者被随机分为胰岛素单药组或胰岛素加利拉鲁肽 0.6mg/天组。我们评估了平均 M 值,该值表示从第 1 天到第 10 天目标血糖水平的接近指数。

结果

利拉鲁肽联合胰岛素组的平均 M 值明显低于胰岛素单药组(利拉鲁肽联合胰岛素 5.8 与胰岛素单药 12.3;P < 0.001)。利拉鲁肽联合胰岛素组胰岛素剂量调整的频率明显低于胰岛素单药组(比值比 0.19,95%CI 0.08-0.49;P < 0.001)。利拉鲁肽联合胰岛素组低血糖的频率趋于低于胰岛素单药组(比值比 0.57,95%CI 0.15-2.23;P = 0.21)。

结论

这项研究的结果表明,与胰岛素单药相比,低剂量利拉鲁肽联合胰岛素可降低 M 值,提示低剂量利拉鲁肽的添加可能在围手术期实现更好的血糖控制。(临床试验注册号:UMIN 000008003)。

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