胰岛素联合治疗的新选择--基础胰岛素+GLP-1受体激动剂被引量：3

The New Choice-of Insulin Combination Therapy of Insulin + GLP-1 Agonists

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摘要糖尿病严重危害人类健康,其治疗也受到越来越多的重视。基础胰岛素可以增加外周对葡萄糖的利用,减少肝糖输出,有效控制空腹血糖,但可能增加体重、加重胰岛素抵抗。而GLP-1受体激动剂类药物可促进和恢复内源胰岛素的分泌,抑制胰高血糖素分泌,同时延缓胃排空、抑制食欲,从而减轻体重、改善胰岛素抵抗。GLP-1主要降低餐后血糖,与餐时胰岛素相比,明显降低了低血糖风险。基础胰岛素与GLP-1受体激动剂联合应用可扬长避短,发挥协同互补的作用,成为2型糖尿病治疗的新选择。 Diabetes cause serious damage to human health, thus the treatment has become more and more important. Basal insulin can increase the glucose utilization in peripheral insulin, reduce glycogen output, effectively control blood sugar on an empty stomach, but may increase the body weight, increase insulin resistance. And glp-1 agonist drugs can promote and restore endogenous insulin secretion, suppress glucagon secretion, at the same time delay gastric emptying, suppress appetite, and weight loss, and improve insulin resistance. Glp-1 may reduce postprandial blood glucose; insulin when compared to the meal significantly reduces the risk of hypoglycemia. Insulin and combined glp-1 agonists can foster strengths and circumvent weaknesses, thus play an important role in the treatment of type 2 diabetes.

作者郭畅李强

机构地区哈尔滨医科大学附属第二医院内分泌代谢病科一病区、糖尿病医院

出处《药品评价》 CAS 2016年第7期28-32,共5页 Drug Evaluation

基金国家自然科学基金(编号81170744,81370902)

关键词 GLP-1受体激动剂基础胰岛素糖尿病 GLP-1 Agonists Insulin Diabetes

分类号 R587.1 [医药卫生—内分泌]

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1Turner RC, Cull CA, Frighi V, et al. Glycemic control with diet, stttfotxyturea, metformin, or insulin in patients with type 2 diabetes mellitus: progressive requirement for multiple therapies (UKPDS 49) UK Prospective Diabetes Study (UKPDS) Group[J]. JAMA, 1999, 281(2) ): 2005-2012.
2Pennartz C, Schenker N, Menge B, et al. Chronic reduction of fasting glycemia with insulin glargine improves first- and second-phase insulin secretion in patients with type 2 diabetes[J]. Diabetes Care, 2011 Sep, 34(9): 2048-2053.
3Opinto G, Natalicchio A, Marchetti E Physiology of incretins and loss of incretin effect in type 2 diabetes and obesity[J]. Arch Physiol Biochem, 2013 Oct, 119(4): 170-178.
4Hoist JJ, Knop FK, Vilsboll T, et al. Loss of incretin effect is a specific, important, and early characteristic of type 2 diabetes[J]. Diabetes Care, 2011 May, 34(Suppl 2):S251-257.
5Tasyurek HM, Altunbas HA, Balci MK, et al. lncretins: their physiology and application in the treatment of diabetes mellitus[J]. Diabetes Metab Res Rev, 2014 Jul, 30(5): 354-371.
6van der Klauw MM, Wolffenbuttel BH. The combination of insulin and GLP-I analogues in the treatment of type 2 diabetes[J]. Neth J Med, 2012 Dec, 70(10): 436-443.
7Urusova IA, Farilla L, Hui H, et al. GLP-1 inhibition of pancreatic islet cell apoptosis. Trends Endocrinol Metab[J]. Trends Endocrinol Metab, 2004 Jan-Feb, 15(1): 27-33.
8Buse JB, Bergenstal RM, Glass LC, et al. Use of twice-daily exenatide in basal insulin-treated patients with type 2 diabetes: a randomized, controlled trial[J]. Ann Intern Med, 2011 Jan 18, 154(2): 103-112.
9Buse JB, Han J, Miller S, et al. Addition of exenatide BID to insulin glargine: a post-hoc analysis of the effect on glycemia and weight across arange of insulin titration[J]. Curr Med Res Opin. 2014 Jul, 30(7): 1209-1218.
10de Wit HM, Vervoort GM, Jansen H J, et al. Liraglutide reverses pronounced insulin-associated weight gain, improves glycaemic control and decreasesinsulin dose in patients with type 2 diabetes: a 26 week, randomised clinical trial (ELEGANT)[J]. Diabetologia, 2014 Sep, 57(9): 1812-1819.