近年来,糖尿病已成为继肿瘤和心脑血管疾病之后第3位严重危害人类健康的慢性疾病^（[1-3]）。其中2型糖尿病占糖尿病患者的90%。Dulaglutide（商品名Trulicity）是由礼莱公司（Eli Lilly and Company）研发的一种胰高血糖素样肽（glucag...近年来,糖尿病已成为继肿瘤和心脑血管疾病之后第3位严重危害人类健康的慢性疾病^（[1-3]）。其中2型糖尿病占糖尿病患者的90%。Dulaglutide（商品名Trulicity）是由礼莱公司（Eli Lilly and Company）研发的一种胰高血糖素样肽（glucagonlikepeptide 1,GLP-1）受体激动剂,用于治疗成人2型糖尿病,与其他治疗糖尿病的药物相比,展开更多
<p align="justify"> <span style="font-family:Verdana;">Glucagon like peptide-1 is responsible for the incretin effect after a meal or an oral glucose load. Patients with type 2 diabetes...<p align="justify"> <span style="font-family:Verdana;">Glucagon like peptide-1 is responsible for the incretin effect after a meal or an oral glucose load. Patients with type 2 diabetes mellitus have impairment of secretion and action of glucagon like peptide-1. This impairment can be overcome through pharmacological doses of glucagon like peptide-1 analogues. <strong>Aim of the Study:</strong> This study aimed at evaluation of the effect of treatme</span><span style="font-family:Verdana;">nt with glucagon like peptide-1 analogues;liraglutide and dulaglutide, in Emirati patients with type 2 diabetes mellitus. Glycemic control was the primary end point while the secondary end point was the effect on body mass index, blood pressure, heart rate, serum creatinine, lipid profile and estimated glomerular filtration rate. <strong>Patients & Methods:</strong> This is a retrospective study including 54 patients with type 2 diabetes mellitus. Patients used Liraglutide or Dulaglutide as add on therapy to oral antidiabetic medications for one year. Thirty-four patients used liraglutide 1.8 mg once daily and 20 patients used dulaglutide 1.5 mg once weekly. All patients were older than 18 years and had estimated glomerular filtration rate (>90 ml/min/1.73 m2). Body mass index, sitting blood pressure and heart rate were collected. Fasting plasma glucose, HbA1c, lipid panel and other biochemical parameters were also collected. Data were analysed before and at 6 and 12 months of glucagon like peptide-1 analogue treatment. <strong>Results:</strong> At 12 months of treatment, liraglutide significantly reduced fasting plasma glucose (11.3 ± 4 vs 7 ± 1.7, p < 0.001), HbA1c (8.55 ± 1.6 vs 7.18 ± 1.04, p < 0.001) and body mass index (39.4 ± 6.4 vs 37.6 ± 6.7, p < 0.0005). Dulaglutide did not significantly reduce fasting plasma glucose (15.4 ± 3.5 vs 9.5 ± 5.4 mmol/L, p = 0.053), significantly reduced HbA1c (8.84 ± 1.8 vs 7.5 ± 0.79, p = 0.007), body mass index (38.8 ± 6.8 vs 37.2 ± 6.6, p = 0.004) and estimated glomerular filtration rate (123.6 ± 60 vs 104 ± 47.3, p = 0.008). Dulaglutide was more effective in reduction of body mass index than liraglutide. Both drugs did not show significant effect on blood pressure, heart rate or lipid profile. <strong>Conclusion: </strong>Over a period of one year, liraglutide and dulaglutide produced comparable reduction of HbA1c and hence diabetes control. Both drugs significantly reduced body mass index but this effect was more pronounced with Dulaglutide. Only liraglutide significantly reduced fasting plasma glucose. Dulaglutide significantly reduced estimated glomerular filtration rate. There was no significant effect of liraglutide or dulaglutide on blood pressure, heart rate or lipid profile.</span> </p>展开更多
Chronic kidney disease constitutes a major microvascular complication of diabetes mellitus.Accumulating data suggest that glucagon-like peptide-1 receptor agonists(GLP-1 RAs)might have a role in the management of diab...Chronic kidney disease constitutes a major microvascular complication of diabetes mellitus.Accumulating data suggest that glucagon-like peptide-1 receptor agonists(GLP-1 RAs)might have a role in the management of diabetic kidney disease(DKD).GLP-1 RAs appear to reduce the incidence of persistent macro-albuminuria in patients with type 2 diabetes mellitus.This beneficial effect appears to be mediated not only by the glucose-lowering action of these agents but also on their blood pressure lowering,anti-inflammatory and antioxidant effects.On the other hand,GLP-1 RAs do not appear to affect the rate of decline of glomerular filtration rate.However,this might be due to the relatively short duration of the trials that evaluated their effects on DKD.Moreover,these trials were not designed nor powered to assess renal outcomes.Given than macrolbuminuria is a strong risk factor for the progression of DKD,it might be expected that GLP-1 RAs will prevent the deterioration in renal function in the long term.Nevertheless,this remains to be shown in appropriately designed randomized controlled trials in patients with DKD.展开更多
文摘近年来,糖尿病已成为继肿瘤和心脑血管疾病之后第3位严重危害人类健康的慢性疾病^（[1-3]）。其中2型糖尿病占糖尿病患者的90%。Dulaglutide（商品名Trulicity）是由礼莱公司（Eli Lilly and Company）研发的一种胰高血糖素样肽（glucagonlikepeptide 1,GLP-1）受体激动剂,用于治疗成人2型糖尿病,与其他治疗糖尿病的药物相比,
文摘<p align="justify"> <span style="font-family:Verdana;">Glucagon like peptide-1 is responsible for the incretin effect after a meal or an oral glucose load. Patients with type 2 diabetes mellitus have impairment of secretion and action of glucagon like peptide-1. This impairment can be overcome through pharmacological doses of glucagon like peptide-1 analogues. <strong>Aim of the Study:</strong> This study aimed at evaluation of the effect of treatme</span><span style="font-family:Verdana;">nt with glucagon like peptide-1 analogues;liraglutide and dulaglutide, in Emirati patients with type 2 diabetes mellitus. Glycemic control was the primary end point while the secondary end point was the effect on body mass index, blood pressure, heart rate, serum creatinine, lipid profile and estimated glomerular filtration rate. <strong>Patients & Methods:</strong> This is a retrospective study including 54 patients with type 2 diabetes mellitus. Patients used Liraglutide or Dulaglutide as add on therapy to oral antidiabetic medications for one year. Thirty-four patients used liraglutide 1.8 mg once daily and 20 patients used dulaglutide 1.5 mg once weekly. All patients were older than 18 years and had estimated glomerular filtration rate (>90 ml/min/1.73 m2). Body mass index, sitting blood pressure and heart rate were collected. Fasting plasma glucose, HbA1c, lipid panel and other biochemical parameters were also collected. Data were analysed before and at 6 and 12 months of glucagon like peptide-1 analogue treatment. <strong>Results:</strong> At 12 months of treatment, liraglutide significantly reduced fasting plasma glucose (11.3 ± 4 vs 7 ± 1.7, p < 0.001), HbA1c (8.55 ± 1.6 vs 7.18 ± 1.04, p < 0.001) and body mass index (39.4 ± 6.4 vs 37.6 ± 6.7, p < 0.0005). Dulaglutide did not significantly reduce fasting plasma glucose (15.4 ± 3.5 vs 9.5 ± 5.4 mmol/L, p = 0.053), significantly reduced HbA1c (8.84 ± 1.8 vs 7.5 ± 0.79, p = 0.007), body mass index (38.8 ± 6.8 vs 37.2 ± 6.6, p = 0.004) and estimated glomerular filtration rate (123.6 ± 60 vs 104 ± 47.3, p = 0.008). Dulaglutide was more effective in reduction of body mass index than liraglutide. Both drugs did not show significant effect on blood pressure, heart rate or lipid profile. <strong>Conclusion: </strong>Over a period of one year, liraglutide and dulaglutide produced comparable reduction of HbA1c and hence diabetes control. Both drugs significantly reduced body mass index but this effect was more pronounced with Dulaglutide. Only liraglutide significantly reduced fasting plasma glucose. Dulaglutide significantly reduced estimated glomerular filtration rate. There was no significant effect of liraglutide or dulaglutide on blood pressure, heart rate or lipid profile.</span> </p>
文摘Chronic kidney disease constitutes a major microvascular complication of diabetes mellitus.Accumulating data suggest that glucagon-like peptide-1 receptor agonists(GLP-1 RAs)might have a role in the management of diabetic kidney disease(DKD).GLP-1 RAs appear to reduce the incidence of persistent macro-albuminuria in patients with type 2 diabetes mellitus.This beneficial effect appears to be mediated not only by the glucose-lowering action of these agents but also on their blood pressure lowering,anti-inflammatory and antioxidant effects.On the other hand,GLP-1 RAs do not appear to affect the rate of decline of glomerular filtration rate.However,this might be due to the relatively short duration of the trials that evaluated their effects on DKD.Moreover,these trials were not designed nor powered to assess renal outcomes.Given than macrolbuminuria is a strong risk factor for the progression of DKD,it might be expected that GLP-1 RAs will prevent the deterioration in renal function in the long term.Nevertheless,this remains to be shown in appropriately designed randomized controlled trials in patients with DKD.
