Departamento de Medicina Interna, Hospital General, Centro Médico Nacional "La Raza", Instituto Mexicano del Seguro Social, Ciudad de México, Mexico; Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México, Mexico.
División de Investigación en Salud, Hospital de Especialidades, Centro Médico Nacional "La Raza", Instituto Mexicano del Seguro Social, Ciudad de México, Mexico.
Rev Clin Esp (Barc). 2022 Mar;222(3):180-189. doi: 10.1016/j.rceng.2021.09.003. Epub 2021 Dec 4.
Incretin-based therapy leads to glycemic control in a glucose-dependent manner with a low risk of hypoglycemia, making it appealing for use in the hospital. The aim of this systematic review was to assess the benefits of incretin-based therapy in patients with type 2 diabetes hospitalized outside of the intensive care unit. We searched for studies published up to August 2021 in the PubMed and Scopus databases. Clinical trials comparing incretin-based therapy (alone or in combination with insulin) versus an insulin regimen were selected. The results of the included studies showed that incretin-based therapy showed mean blood glucose values, a percentage of records within the therapeutic target, and a percentage of treatment failure similar to insulin management, particularly in patients with mild to moderate hyperglycemia. Furthermore, incretin-based treatment was associated with a lower total insulin dose and a lower incidence of hypoglycemia. In conclusion, incretin-based therapy achieved glycemic control similar to insulin treatment in patients with type 2 diabetes hospitalized outside the intensive care unit and has the advantages of reducing the insulin requirement and a lower risk of hypoglycemia.
基于肠促胰岛素的治疗以葡萄糖依赖的方式导致血糖控制，低血糖风险低，因此在医院中很有吸引力。本系统评价的目的是评估肠促胰岛素治疗在重症监护室外住院的 2 型糖尿病患者中的益处。我们在 PubMed 和 Scopus 数据库中搜索了截至 2021 年 8 月发表的研究。选择了比较肠促胰岛素治疗（单独或与胰岛素联合）与胰岛素方案的临床试验。纳入研究的结果表明，肠促胰岛素治疗在平均血糖值、治疗目标范围内的记录百分比和治疗失败百分比方面与胰岛素管理相似，尤其是在轻度至中度高血糖患者中。此外，肠促胰岛素治疗与较低的总胰岛素剂量和较低的低血糖发生率相关。总之，肠促胰岛素治疗在重症监护室外住院的 2 型糖尿病患者中实现了与胰岛素治疗相似的血糖控制，并且具有降低胰岛素需求和低血糖风险的优点。
