Hansen Katrine B, Svendstrup Mathilde, Lund Asger, Knop Filip K, Vilsbøll Tina, Vestergaard Henrik
Steno Diabetes Center Copenhagen, Gentofte, Denmark.
Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
Diabet Med. 2021 Oct;38(10):e14655. doi: 10.1111/dme.14655. Epub 2021 Aug 4.
The once-weekly administered glucagon-like peptide 1 (GLP-1) receptor agonist (GLP-1RA) semaglutide, has, in clinical trials, demonstrated significant reductions in glycated haemoglobin A (HbA ) and body weight in persons with type 2 diabetes. We evaluated the real-world clinical effects of semaglutide once weekly in a hospital-based diabetes out-patient clinic.
This retrospective observational cohort study included persons with type 2 diabetes (n = 119) on a broad range of antidiabetic medicine: GLP-1RA naïve persons (n = 37) and GLP-1RA-experienced persons (n = 82). Person characteristics at inclusion: age [median (quartiles)]: 65 (57, 72) years; body weight 99 (86, 118) kg; body mass index (BMI) 33 (29, 38) kg/m²; HbA 61 (54, 69) mmol/mol/(7.7 (7.1, 8.5) %). Data were collected at baseline and after 3, 6 and 12 months of semaglutide treatment. Data were analysed using a general linear mixed model for repeated measurements.
After 12 months, the reductions in HbA were (mean [95% confidence interval]: GLP-1RA naïve: -12.8 [-17.0, -8.5] mmol/mol/ -1.2 [-1.6, -0.8]% (p < 0.01) and GLP-1RA experienced: -6.4 [-9.0, -3.8] mmol/mol/ -0.6 [-0.8, -0.4]% (p < 0.01), respectively. Body weight reductions in GLP-1RA naïve: -5 [-6.9, -3.1] kg (p < 0.01) and GLP-1RA experienced: -3.2 [-4.4, -2.0] kg (p < 0.01), respectively. Seventy-five percent received 1 mg QW semaglutide.
We observed effects of semaglutide once weekly on HbA and body weight comparable with the effects observed in clinical studies with fewer persons in our cohort receiving maximum dose of semaglutide.
每周一次给药的胰高血糖素样肽1（GLP-1）受体激动剂（GLP-1RA）司美格鲁肽在临床试验中已证明可使2型糖尿病患者的糖化血红蛋白A（HbA）和体重显著降低。我们在一家医院的糖尿病门诊评估了每周一次使用司美格鲁肽的实际临床效果。
这项回顾性观察性队列研究纳入了使用多种抗糖尿病药物的2型糖尿病患者（n = 119）：未使用过GLP-1RA的患者（n = 37）和有GLP-1RA使用经验的患者（n = 82）。纳入时的个人特征：年龄[中位数（四分位数）]：65（57，72）岁；体重99（86，118）千克；体重指数（BMI）33（29，38）千克/平方米；HbA 61（54，69）毫摩尔/摩尔/（7.7（7.1，8.5）%）。在司美格鲁肽治疗的基线以及3、6和12个月后收集数据。使用重复测量的一般线性混合模型分析数据。
12个月后，HbA的降低幅度为（均值[95%置信区间]）：未使用过GLP-1RA的患者：-12.8[-17.0，-8.5]毫摩尔/摩尔/-1.2[-1.6，-0.8]%（p < 0.01），有GLP-1RA使用经验的患者：-6.4[-9.0，-3.8]毫摩尔/摩尔/-0.6[-0.8，-0.4]%（p < 0.01）。未使用过GLP-1RA的患者体重降低-5[-6.9，-3.1]千克（p < 0.01），有GLP-1RA使用经验的患者体重降低-3.2[-4.4，-2.0]千克（p < 0.01）。75%的患者接受每周一次1毫克的司美格鲁肽。
我们观察到每周一次使用司美格鲁肽对HbA和体重的影响与临床研究中观察到的效果相当，我们队列中接受司美格鲁肽最大剂量的人数较少。
