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1.
《Nutrition, metabolism, and cardiovascular diseases : NMCD》2021,31(11):3193-3201
Background and aimsTo evaluate the change in circulating serum irisin and interleukin-6 (IL-6), in patients with type 2 diabetes mellitus (T2DM) after 6 and 12 months of GLP-1 treatment.Methods and resultsEighty-five patients with T2DM inadequately controlled with insulin or other hypoglycaemic drugs were added to dulaglutide (N° = 44) and liraglutide (N° = 41) treatment.After 6 months of GLP-1 analogues a significant decrease in BMI (p < 0.001), waist circumference (WC) (p < 0.001), fasting blood glucose (p < 0.001), HbA1c (p < 0.001), total cholesterol (p < 0.001), LDL-cholesterol (p = 0.003), triglycerides (p = 0.017), IL-6 (p = 0.045) and a significant increase in serum irisin (p < 0.001) were observed compared to baseline. After 12 months of treatment no significant differences were found compared to the levels at 6 months. The change in irisin from baseline (Δ_irisin) was significantly related to the changes in total-cholesterol (Δ_total-cholesterol) (r = −0.293; p = 0.020), while the change in IL-6 (Δ_IL-6) was significantly related to the changes in WC (Δ_WC) (r = 0.347; p = 0.006).ConclusionsAdditive treatment with GLP1-analogues results in an increase in serum circulating irisin levels and a decrease in IL-6. The post-treatment change in irisin was correlated with a decrease in total cholesterol, while the change in IL-6 was correlated with a decrease in WC. 相似文献
2.
Takahiro Yajima Kumiko Yajima Makoto Hayashi Hiroshi Takahashi Keigo Yasuda 《Journal of diabetes and its complications》2018,32(3):310-315
Aims
To evaluate the efficacy and safety of adding once-weekly dulaglutide to insulin therapy in type 2 diabetes mellitus (T2DM) patients on hemodialysis.Methods
Fifteen insulin-treated T2DM patients on hemodialysis were enrolled. Continuous glucose monitoring was performed before (1st hospitalization) and after the fifth dulaglutide administration (2nd hospitalization). The insulin dose was reduced after the first administration of dulaglutide (1st hospitalization day 6). Parameters of glycemic control were compared on 1st hospitalization days 4–5, 2nd hospitalization days 3–4, and days 6–7.Results
The median total daily insulin dose was reduced significantly from 12 (12–25) to 0 (0?12) U (p?<?0.0001) after treatment with dulaglutide. Mean glucose level on 2nd hospitalization days 3–4 significantly decreased and that on days 6–7 tended to decrease compared with that on 1st hospitalization days 4–5 (median, 8.2 to 6.7?mmol/L, P?=?0.006 and 8.2 to 6.9?mmol/L, P?=?0.053, respectively). %CV of glucose levels decreased significantly after dulaglutide administration (28.1 to 19.8, P?=?0.003 and 28.1 to 21.0, P?=?0.019). However, the incidence of hypoglycemia remained unchanged.Conclusions
Dulaglutide may improve glycemic control and excursion and allow total daily insulin to be reduced without increasing the risk of hypoglycemia in T2DM patients on hemodialysis. 相似文献3.
目的 评价Dulaglutide治疗2型糖尿病的有效性和安全性.方法 计算机检索Cochrane图书馆、PubMed、OVID、Medline、Embase、知网、万方、维普等数据库,按Cochrane系统评价的方法评价纳入研究的质量,并使用RevMan 5.2软件进行Meta分析.结果 共纳入10项研究,6 699例患者.Meta分析结果显示,Dulaglutide在降低糖化血红蛋白(HbA1c)[阳性对照组:均数差(MD) =-0.32,95％CI(-0.42,-0.22),P＜0.01;安慰剂:MD=-1.07,95％CI(-1.16,-0.99),P＜0.01]、空腹血糖(FPG)[阳性对照组:MD=-0.60,95％CI(-0.84,-0.36),P＜0.01;安慰剂:MD=-1.86,95％CI(-1.88,-1.84),P＜0.01]、体质量方面[阳性对照组:MD=-0.95,95％CI(-1.69,-0.21),P=0.010;安慰剂:MD=-1.31,95％CI(-2.13,-0.49),P=0.002]优于阳性对照组或安慰剂.安全性方面,Dulaglutide与阳性对照组及安慰剂相比,低血糖发生风险和总不良反应发生率差异无统计学意义(P＞0.05).结论 Dulaglutide治疗2型糖尿病安全有效. 相似文献
4.
André J. Scheen 《Expert review of clinical pharmacology》2016,9(3):385-399
Dulaglutide is a new once-weekly glucagon-like peptide-1 receptor agonist for the management of hyperglycemia in adult patients with type 2 diabetes. It stimulates dose-dependent insulin secretion and reduces glucagon secretion, both in a glucose-dependent manner. Efficacy on blood glucose control and safety were demonstrated in the large AWARD program in type 2 diabetic patients treated with diet, metformin, dual oral therapy or insulin lispro with or without metformin, confirming findings of pilot studies in Caucasian patients and data in Japanese patients. Dulaglutide 1.5 mg once weekly was superior to metformin, sitagliptin, insulin glargine and exenatide twice daily, and non-inferior to liraglutide 1.8 mg once daily regarding the reduction in glycated hemoglobin. A modest but significant weight loss was consistently observed. Most frequent adverse events were transient and generally mild gastrointestinal disturbances. Clinical outcomes of dulaglutide will not be known until the large prospective cardiovascular outcome trial REWIND is complete. 相似文献
5.
目的比较度拉糖肽注射液和利拉鲁注射液肽联合盐酸二甲双胍片治疗超重及肥胖2型糖尿病患者的临床疗效。方法选择2019年8月—2020年8月就诊于天津市第二医院门诊的68例超重及肥胖2型糖尿病患者,采用随机数字表法将所有患者分为对照组和治疗组,每组各34例。所有患者口服盐酸二甲双胍片,1500mg/d。对照组给予利拉鲁肽注射液,起始剂量为每日7:00皮下注射0.6mg,根据血糖水平和患者的反应逐步增加剂量,最大剂量为1.8mg/d。治疗组给予度拉糖肽注射液,起始剂量为每10天于7:00皮下注射度拉糖肽注射液1.5 mg,根据血糖和患者的耐受情况逐步调整为每周固定一天7:00皮下注射度拉糖肽注射液1.5 mg。两组患者连续治疗24周。观察两组患者的临床疗效,比较两组患者治疗前后的血糖、糖化血红蛋白(HbA1c)、体质量指数(BMI)、胰岛素抵抗指数(HOMA-IR)的变化。结果治疗后,对照组和治疗组总有效率分别为94.12%、97.06%,治疗组总有效率高于对照组,但两组总有效率比较差异无统计学意义。治疗后,两组空腹血糖(FPG)、餐后2小时血糖(2 h PPG)、HbA1c、BMI均显著低于治疗前(P0.05);治疗后两组FPG、2 h PPG、HbA1c、BMI比较差异无统计学意义。治疗后,两组HOMA-IR均低于治疗前,差异有统计学意义(P0.05);治疗后两组HOMA-IR比较差异无统计学意义。两组间HOMA-IR下降值比较无统计学差异。结论度拉糖肽注射液和利拉鲁肽注射液联合盐酸二甲双胍片治疗超重及肥胖2型糖尿病的疗效显著,降糖同时减重,改善胰岛素抵抗,值得推广。 相似文献
6.
《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2020,14(4):289-292
AimsBinge eating disorder (BED) is the most common eating disorder in the United States and Europe and is associated with obesity and type 2 diabetes (T2D). Presence and severity of BED have been associated with worse metabolic control and greater BMI in T2D patients. Glucagon Like Peptide-1 (GLP1) receptors are present in central nervous system areas involved in appetite regulation and treatment with GLP-1 receptor agonists modulates appetite and reward-related brain areas in humans. We evaluated the effects of treatment with dulaglutide on eating behavior in T2D outpatients with BED.MethodsThis was a pilot open label, prospective controlled study. Inclusion criteria were: Age ≤65, HbA1c between 7.5 and 9% on metformin therapy alone, normal renal function and diagnosis of BED. Patients were randomly assigned to receive either Dulaglutide 1,5 mg/sett or Gliclazide 60 mg for 12 weeks. We evaluated baseline binge eating scale score (BES), weight, BMI, percentage fat mass, HbA1c and their changes after treatment. A multivariate linear regression model was used to verify the association between Δ BES from baseline with Δ Hba1c and variation of anthropometric parameters after treatment.ResultsAfter 12 weeks patients treated with dulaglutide had grater reduction of binge eating behaviour (p < 0.0001), body weight (p < 0,0001), BMI (p < 0.0001), percentage fat mass (p < 0.0001) and HbA1c (p = 0.009) than patients treated with gliclazide. Reduction in BES was associated with reduction in body weight (p < 0.0001) and HbA1c (p = 0.033).ConclusionDulaglutide treatment reduces binge eating behaviour in T2D patients with BED. 相似文献
7.
T. Kimura A. Obata M. Shimoda H. Hirukawa Y. Kanda-Kimura Y. Nogami K. Kohara S. Nakanishi T. Mune K. Kaku H. Kaneto 《Diabetes & metabolism》2018,44(3):250-260
Aims
It is well-known that chronic exposure to large amounts of ligand leads to downregulation of its receptor. It is not known, however, whether a GLP-1R agonist downregulates its receptor. For this reason, our study examined whether GLP-1R expression is reduced after long-term exposure to dulaglutide (Dula) in non-diabetic and diabetic mice.Methods
Seven-week-old male db/db and db/m mice were given either Dula (0.6 mg/kg × 2/week) or a control vehicle (CTL) for 17 weeks. Various metabolic parameters, such as glucose-stimulated insulin secretion (GSIS), insulin and TG content in islets, were evaluated after the intervention. β-cell-related gene expression was also analyzed by real-time RT-PCR.Results
In db/m mice, GLP-1R expression in β-cells did not decrease, not even after long-term administration of Dula, compared with control mice, while GLP-1R expression in 24-week-old db/db mice treated with Dula was augmented, rather than downregulated, compared with 24-week-old CTL db/db mice. This was probably due to improved glycaemic control. In db/db mice treated with Dula, food intake and blood glucose levels were significantly decreased up to 24 weeks of age compared with CTL db/db mice, and their expression levels of various β-cell-related genes, insulin content and GSIS were also enhanced. In contrast, oxidative and endoplasmic reticulum stress, inflammation, fibrosis and apoptosis were suppressed with Dula treatment.Conclusion
Dula exerts beneficial effects on glycaemic control and has long-lasting protective effects on pancreatic β-cells. GLP-1R expression levels were not reduced at all in non-diabetic as well as diabetic mice despite long-term dulaglutide exposure. 相似文献8.
目的：研究度拉糖肽应用于2型糖尿病（T2DM）患者常规治疗对临床指标的影响。方法：选取2021年1月至2022年6月漯河市第二人民医院收治的78例T2DM合并体质量超标的患者,随机分为对照组和观察组,每组39例。对照组患者采用常规治疗,观察组患者在常规治疗的基础上应用度拉糖肽治疗,比较两组患者临床指标的变化情况。结果：治疗后,观察组患者血清糖化血红蛋白（Hb A1c）、空腹血糖（FPG）、餐后2 h血糖（2h PG）水平均低于对照组,空腹C肽（FCP）水平高于对照组,差异具有统计学意义（P <0.05）;治疗后,观察组患者体质量、体质量指数、腰围均低于对照组,差异具有统计学意义（P <0.05）;治疗后,观察组患者三酰甘油、总胆固醇、低密度脂蛋白胆固醇水平均低于对照组,差异具有统计学意义（P <0.05）;治疗后,观察组患者血清瘦素、脂联素水平均高于对照组,胰岛素抵抗指数低于对照组,差异具有统计学意义（P <0.05）。结论：度拉糖肽应用于T2DM常规治疗中可进一步改善患者相关临床指标,提高临床疗效。 相似文献
9.
John E. Anderson Vivian T. Thieu Kristina S. Boye Ryan T. Hietpas 《Postgraduate medicine》2016,128(8):810-821
Approximately 90% of T2D patients in the US are diagnosed and treated in the primary care setting, and the majority of the burden of disease management falls to primary care providers. Here, we discuss the clinical data for once weekly dulaglutide, e.g. the results of seven completed Phase 3 trials, patient preference studies, patient reported outcomes (PRO), and clinical data surrounding the dulaglutide administration device. Dulaglutide 1.5 mg once weekly demonstrated superiority to placebo, metformin, sitagliptin, exenatide BID, and insulin glargine (in 2 trials), and non-inferiority to liraglutide in reduction of HbA1c from baseline, with an acceptable safety profile. Dulaglutide-treated patients achieved the composite endpoint of an HbA1c <7.0% with no hypoglycemia, no severe hypoglycemia, and no weight gain significantly more than metformin, sitagliptin, exenatide BID or insulin glargine treated patients. Dulaglutide consistently showed an early onset of glycemic control, lasting up to 104 weeks. Additionally, PRO and patient preference data support the benefit of once weekly dulaglutide for the treatment of T2D. 相似文献
10.
Takahiro Yajima Kumiko Yajima Hiroshi Takahashi Keigo Yasuda 《Journal of diabetes and its complications》2018,32(8):759-763