基础胰岛素与GLP-1RA复方制剂IDegLira的降糖机制与临床实践探讨

The Rationale and Clinical Practice of IDegLira,a Fixed-ratio Combination Preparation of Basal Insulin and GLP-1RA,in Glycemic Control

2型糖尿病(T2DM)是一种进展性疾病,其病理生理机制复杂,涉及多个器官。基础胰岛素通过抑制肝脏中糖原分解和糖异生作用而减少肝糖输出;胰高糖素样肽-1受体激动剂(GLP-1RA)以葡萄糖浓度依赖的方式促进胰岛素分泌、抑制胰高糖素分泌。两者降糖机制互补,为联合治疗提供了理论依据。德谷胰岛素/利拉鲁肽复方制剂(IDegLira)是长效基础胰岛素类似物和GLP-1RA的固定比例复方制剂,每日一次注射治疗,为T2DM治疗提供了一种有效、安全的治疗方案。本文将从该复方制剂的作用机制、疗效及安全性进行综述,以供临床医师参考。

Type 2 diabetes mellitus(T2DM)is a progressive disease with complex pathophysiological mechanisms which involve multiple organs.Basal insulin reduces hepatic glucose output by inhibiting hepatic glycogenolysis and gluconeogenesis.Glucagon-like peptide-1 receptor agonist(GLP-1RA)enhances insulin secretion and inhibit glucagon secretion in a glucosedependent manner.Their complementary hypoglycemic mechanisms provide the theoretical basis for a combination therapy.Insulin degludec/liraglutide(IDegLira)is a fixed-ratio combination preparation of a long-acting basal insulin analogue and a GLP-1RA.It is injected once a day to provide an effective and safe regimen for the treatment of T2DM.This review discusses the mechanism,efficacy and safety of IDegLira to provide a reference for the clinicians.