Yamada Tomoko, Asahara Shun-Ichiro, Kimura-Koyanagi Maki, Tamori Yoshikazu, Muramae Naokazu, Mori Kenta, Okano Mitsumasa, Otsui Kazunori, Sakaguchi Kazuhiko
Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017 Japan.
Division of General Internal Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
Diabetol Int. 2023 Apr 10;14(3):294-297. doi: 10.1007/s13340-023-00621-5. eCollection 2023 Jul.
Fixed-ratio combination injection therapy (FRC) is a fixed-ratio mixture containing basal insulin and glucagon-like peptide-1 receptor agonist (GLP-1 RA) in a single injection for the treatment of patients with type 2 diabetes. The two types of FRC products contain different concentrations and mixing ratios of basal insulin and GLP-1 RA. Both products demonstrated satisfactory blood glucose control throughout the day, with less hypoglycemia and weight gain. However, few studies have examined the differences in the actions of the two formulations. Herein, we present a case of a 71-year-old man with pancreatic diabetes and significantly impaired intrinsic insulin secretion capacity, who demonstrated a marked difference in glycemic control following treatment with two different FRC formulations. Treatment with IDegLira, an FRC product, demonstrated suboptimal glucose control in the patient. However, after a change in therapy to another FRC product, IGlarLixi, his glucose control markedly improved, even with a decrease in the injection dose. This difference could have been due to lixisenatide, a short-acting GLP-1RA contained in IGlarLixi, which exerts a postprandial hypoglycemic effect irrespective of intrinsic insulin secretion capacity. In conclusion, IGlarLixi has the potential to achieve good fasting and postprandial glucose control with a once-daily injection, even in patients with type 2 diabetes who have a reduced intrinsic insulin secretion capacity.
The online version contains supplementary material available at 10.1007/s13340-023-00621-5.
固定比例联合注射疗法（FRC）是一种将基础胰岛素和胰高血糖素样肽-1受体激动剂（GLP-1 RA）按固定比例混合于单次注射中的疗法，用于治疗2型糖尿病患者。两种FRC产品所含基础胰岛素和GLP-1 RA的浓度及混合比例不同。两种产品均显示出全天令人满意的血糖控制效果，低血糖和体重增加情况较少。然而，很少有研究考察这两种制剂作用的差异。在此，我们报告一例71岁的胰腺性糖尿病男性患者，其自身胰岛素分泌能力显著受损，在接受两种不同FRC制剂治疗后，血糖控制表现出明显差异。使用FRC产品德谷胰岛素利拉鲁肽治疗时，该患者的血糖控制欠佳。然而，在换用另一种FRC产品甘精胰岛素利司那肽治疗后，即便注射剂量减少，其血糖控制仍显著改善。这种差异可能归因于甘精胰岛素利司那肽中含有的短效GLP-1 RA利司那肽，它无论患者自身胰岛素分泌能力如何，均可发挥餐后降糖作用。总之，即使对于自身胰岛素分泌能力降低的2型糖尿病患者，甘精胰岛素利司那肽也有潜力通过每日一次注射实现良好的空腹和餐后血糖控制。
在线版本包含可在10.1007/s13340-023-00621-5获取的补充材料。
