Barajas A G, Gagnon-Vargas Charles A, Schmitt Jessica A
University of Alabama at Birmingham Marnix E. Heersink School of Medicine, Birmingham, Alabama, USA.
Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, University of Alabama at Birmingham Marnix E. Heersink School of Medicine, Birmingham, Alabama, USA.
Endocrinol Diabetes Metab. 2025 May;8(3):e70053. doi: 10.1002/edm2.70053.
Incidence of type 2 diabetes mellitus (T2DM) and obesity is increasing in children. We aimed to observe the metabolic health effects of glucagon-like peptide 1 (GLP-1) receptor agonists in paediatric patients with T2DM in a real-world setting.
A retrospective chart review of patients aged 0 to 18 years with T2DM who were started on a GLP-1 receptor agonist between August 2019 and August 2023 and followed for up to 24 months was included in this study.
321 patients were included in the analysis. After 12 months of treatment with a GLP-1 receptor agonist, haemoglobin A1c (HbA1c) was reduced by -1.04% ± 2.3% (p < 0.001). At 24 months, HbA1c was similar to baseline (8.3% ± 2.5% vs. 7.9% ± 2.5%, p = 0.24). There was a significant (p < 0.05) decrease in the use of metformin, basal insulin, and bolus insulin at one year which was sustained at the two-year follow-up for metformin (p = 0.002). Overall, there was no significant change in BMI nor other metabolic parameters while undergoing treatment with a GLP-1 receptor agonist.
Paediatric patients with T2DM using GLP-1 receptor agonists experienced a significant decrease in HbA1c after 12 months of use, which was not sustained at 24 months. However, patients had a reduction in insulin and metformin use at 12 months. No significant impact was appreciated on BMI or other metabolic variables.
2型糖尿病（T2DM）和肥胖症在儿童中的发病率正在上升。我们旨在观察胰高血糖素样肽1（GLP-1）受体激动剂在现实环境中对儿科T2DM患者代谢健康的影响。
本研究纳入了2019年8月至2023年8月期间开始使用GLP-1受体激动剂并随访长达24个月的0至18岁T2DM患者的回顾性病历审查。
321名患者纳入分析。使用GLP-1受体激动剂治疗12个月后，糖化血红蛋白（HbA1c）降低了-1.04%±2.3%（p<0.001）。在24个月时，HbA1c与基线相似（8.3%±2.5%对7.9%±2.5%，p=0.24）。一年时二甲双胍、基础胰岛素和推注胰岛素的使用显著减少（p<0.05），二甲双胍在两年随访时仍持续减少（p=0.002）。总体而言，在使用GLP-1受体激动剂治疗期间，BMI和其他代谢参数没有显著变化。
使用GLP-1受体激动剂的儿科T2DM患者在使用12个月后HbA1c显著降低，但在24个月时未持续。然而，患者在12个月时胰岛素和二甲双胍的使用减少。对BMI或其他代谢变量没有显著影响。
