Luo Yi, Ding Bo, Xia Wen-Qing, Liu Bing-Li, Ge Sheng-Hui, Yuan Lu, Ma Jian-Hua
Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210000, China.
J Endocrinol Invest. 2025 Jul 28. doi: 10.1007/s40618-025-02665-7.
To explore the efficacy and safety of continuous subcutaneous glucagon-like peptide-1 receptor agonist infusion (CSGI) combined with continuous subcutaneous insulin infusion (CSII) on body weight, glycemic control and β-cell function in newly diagnosed type 2 diabetes (T2D) patients.
From May 2018 to November 2021, 30 newly diagnosed T2D patients at Nanjing First Hospital were recruited then randomized 1:1 to receive either CSGI add-on to CSII or CSII for 4 weeks. The oral glucose tolerance test (OGTT) and 3-day continuous glucose monitoring (CGM) were performed at the baseline and endpoint. The primary outcome was body weight change from baseline to endpoint.
After treatment for 4 weeks, the CSGI add-on group achieved greater weight reduction (- 8.8 ± 4.5 kg vs. 0.0 ± 1.8 kg; P < 0.001) and BMI decrease (3.0 ± 1.3 vs. 0.0 ± 0.7 kg/m²; P < 0.001) versus CSII alone, with 80% (vs. 0%) losing ≥ 5% body weight (P < 0.001). While glycemic control improved in both groups, the CSGI add-on group required lower insulin doses to maintain euglycemia and showed enhanced β-cell function (P < 0.05). No serious adverse events occurred.
Adding CSGI to CSII therapy significantly led to significant weight loss and glycemic control in new diagnosed T2D patients. This combined approach shows promise but needs more research.
ChiCTR1800015914, registered on 28 April, 2018.
探讨持续皮下注射胰高血糖素样肽-1受体激动剂(CSGI)联合持续皮下胰岛素输注(CSII)对新诊断2型糖尿病(T2D)患者体重、血糖控制及β细胞功能的疗效和安全性。
2018年5月至2021年11月,招募南京医科大学第一附属医院30例新诊断的T2D患者,然后按1:1随机分为两组,分别接受CSII基础上加用CSGI或单纯CSII治疗4周。在基线和终点时进行口服葡萄糖耐量试验(OGTT)和3天连续血糖监测(CGM)。主要结局是从基线到终点的体重变化。
治疗4周后,与单纯CSII组相比,CSII基础上加用CSGI组体重减轻更多(-8.8±4.5 kg vs. 0.0±1.8 kg;P<0.001),体重指数降低更多(3.0±1.3 vs. 0.0±0.7 kg/m²;P<0.001),80%(vs. 0%)的患者体重减轻≥5%(P<0.001)。两组血糖控制均有改善,但CSII基础上加用CSGI组维持血糖正常所需胰岛素剂量更低,且β细胞功能增强(P<0.05)。未发生严重不良事件。
在CSII治疗基础上加用CSGI可使新诊断T2D患者显著减重并改善血糖控制。这种联合治疗方法显示出前景,但仍需更多研究。
ChiCTR1800015914,于2018年4月28日注册。