Terui Sakiko, Akamatsu Ryoichi, Arai Masanori, Inoue Ryota, Okuyama Tomoko, Kyohara Mayu, Li Jinghe, Tsuno Takahiro, Miyashita Daisuke, Togashi Yu, Terauchi Yasuo, Shirakawa Jun
Department of Endocrinology and Metabolism, Graduate School of Medicine, Yokohama City University, Yokohama, Japan.
Laboratory of Diabetes and Metabolic Disorders, Institute for Molecular and Cellular Regulation (IMCR), Gunma University, Maebashi, Japan.
Diabetes Ther. 2021 Nov;12(11):2873-2889. doi: 10.1007/s13300-021-01147-2. Epub 2021 Sep 17.
Dulaglutide is a long-acting glucagon-like peptide 1 receptor agonist that is administered once weekly for the treatment of type 2 diabetes. However, the immediate glucose-lowering effect of dulaglutide after the first administration and the factors affecting the efficacy of the drug remain unclear.
This study was a retrospective and observational study of 80 subjects with type 2 diabetes conducted in a hospitalized setting. The changes (Δ) in the blood glucose (BG) levels at six time points (6-point BG levels) from the baseline (day - 1) to the day after the first administration of 0.75 mg of dulaglutide (day 1) were evaluated. The associations of the Δ 6-point BG levels with the patients' characteristics and laboratory data were also analyzed.
Significant reduction of the fasting BG, preprandial BG, postprandial BG, and standard deviation (SD) of the 6-point BG levels was observed on day 1 as compared to day - 1 (P < 0.0001) and the reduced BG levels were maintained throughout the remaining observation period of 5 days. The baseline serum hemoglobin A1c and glycoalbumin levels were positively correlated with the reduction of the fasting BG. The Δ BG levels were not related to the parameters of insulin-secreting capacity. Insulin treatment was positively associated with the reduction of the 6-point BG levels. Patients without cerebrovascular disease and patients without diabetic retinopathy showed greater improvements of the fasting BG and SD of the 6-point BG levels, respectively. Urinary microalbumin level was positively correlated with improvements of the 6-point BG levels. Dulaglutide reduced the BG levels, irrespective of the previously used class of antidiabetic medication(s).
Dulaglutide achieved reduction in glucose level within 24 h of the first injection. The improvement in the BG levels remained stable for a week in the hospitalized clinical setting.
度拉糖肽是一种长效胰高血糖素样肽-1受体激动剂，每周给药一次用于治疗2型糖尿病。然而，首次给药后度拉糖肽的即时降糖效果以及影响该药物疗效的因素仍不清楚。
本研究是在住院环境中对80例2型糖尿病患者进行的一项回顾性观察研究。评估了从基线（第-1天）到首次给予0.75mg度拉糖肽后第1天的六个时间点（六点血糖水平）的血糖（BG）水平变化（Δ）。还分析了六点血糖水平变化与患者特征和实验室数据之间的关联。
与第-1天相比，第1天观察到空腹血糖、餐前血糖、餐后血糖以及六点血糖水平的标准差（SD）显著降低（P<0.0001），并且在剩余的5天观察期内血糖水平持续降低。基线血清糖化血红蛋白和糖化白蛋白水平与空腹血糖降低呈正相关。血糖变化水平与胰岛素分泌能力参数无关。胰岛素治疗与六点血糖水平降低呈正相关。无脑血管疾病的患者和无糖尿病视网膜病变的患者分别在空腹血糖和六点血糖水平标准差方面有更大改善。尿微量白蛋白水平与六点血糖水平改善呈正相关。无论先前使用的抗糖尿病药物类别如何，度拉糖肽均可降低血糖水平。
度拉糖肽在首次注射后24小时内实现了血糖水平降低。在住院临床环境中，血糖水平的改善在一周内保持稳定。
