二肽基肽酶Ⅳ抑制剂辅助胰岛素治疗1型糖尿病的研究进展

Research progress on DPP-4 inhibitors as adjuvant therapy for insulin in treatment of type 1 diabetes mellitus

二肽基肽酶Ⅳ(DPP-4)抑制剂为一类在2型糖尿病中应用广泛的口服降糖药,其疗效确切、给药方便、总体耐受性好,但目前尚未被批准用于1型糖尿病。国内外相关文献表明在1型糖尿病患者体内DPP-4抑制剂可以辅助胰岛素改善血糖、保护胰岛β细胞功能、降低谷氨酸脱羧酶抗体(GADA)滴度、减少胰岛素剂量,且不增加低血糖风险和体质量。因此,DPP-4抑制剂可能可作为1型糖尿病患者胰岛素的辅助治疗,作用机制可能源于其抑制胰岛α细胞分泌胰高血糖素,通过免疫机制使胰岛β细胞免受摧毁。

DPP-4 inhibitors, a class of effective, convenient and well-tolerated oral hypoglycemic drugs widely used in type 2 diabetes mellitus, have not been approved for type 1 diabetes mellitus yet. Referring to the relevant literatures at home and abroad,we found DPP-4 inhibitors may be an adjuvant therapy for insulin in patients with type 1 diabetes mellitus. They can assist insulin to improve blood glucose, protect function of islet beta cell, reduce GADA titer and decrease insulin dose in patients with type 1 diabetes, without increasing the risk of hypoglycemia and body weight. The mechanism may be that DPP-4 inhibitors can inhibit the secretion of glucagon by islet alpha cells and lessen the destruction of islet beta cells by immune mechanism.