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2 型糖尿病之外的肠促胰岛素。

Incretins beyond type 2 diabetes.

机构信息

Department of Endocrinology, UZ Gasthuisberg, KU Leuven, Leuven, Belgium.

出版信息

Diabetologia. 2023 Oct;66(10):1809-1819. doi: 10.1007/s00125-023-05980-x. Epub 2023 Aug 8.

Abstract

Incretin-based therapies, in particular glucagon-like peptide-1 (GLP-1) receptor agonists, have been evaluated in other forms of diabetes, but randomised controlled trials are mainly limited to people living with type 1 diabetes. In this review we present the evidence issuing from these trials and discuss their clinical implications as well as the difficulties in interpreting the data. In type 1 diabetes, the addition of GLP-1 receptor agonists to intensive insulin therapy lowers weight and required insulin doses compared with placebo, but the effects on glucose control (HbA, risk of hypoglycaemia) are dependent on the different study protocols. Side effects are limited to the gastrointestinal complaints of nausea, vomiting and diarrhoea. We briefly discuss the potential for using GLP-1 receptor agonists as (adjunct) therapies in other forms of diabetes, where the evidence to date is scarce.

摘要

基于肠降血糖素的治疗方法,特别是胰高血糖素样肽-1(GLP-1)受体激动剂,已在其他类型的糖尿病中进行了评估,但随机对照试验主要限于 1 型糖尿病患者。在本综述中,我们介绍了这些试验得出的证据,并讨论了它们的临床意义以及解释数据的困难。在 1 型糖尿病中,与安慰剂相比,将 GLP-1 受体激动剂添加到强化胰岛素治疗中可降低体重和所需的胰岛素剂量,但对血糖控制(HbA、低血糖风险)的影响取决于不同的研究方案。副作用仅限于胃肠道不适,如恶心、呕吐和腹泻。我们简要讨论了 GLP-1 受体激动剂作为(辅助)治疗其他类型糖尿病的潜力,目前这方面的证据还很有限。

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