| 胰岛素联合治疗的新选择——基础胰岛素+GLP-1受体激动剂 |
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| 引用本文： | 戴丹萍, 吴梅. 胰岛素联用肠促胰素类药物的有效性和低血糖风险研究进展[J]. 药学进展, 2018, 42(8): 622-626. |
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| 作者姓名： | 戴丹萍 吴梅 |
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| 作者单位： | 1.宁波大学医学院附属医院药剂科，浙江 宁波 315020 |
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| 摘 要： | 胰岛素治疗可提高外周葡萄糖的利用率, 减少肝糖原输出, 能有效降低空腹血糖, 但往往会引起低血糖、胰岛素抵抗等不良反应。胰高血糖素样肽-1（GLP-1)受体激动剂（GLP-1RA）和二肽基肽酶-4（DPP-4）抑制剂（DPP-4I）作为治疗2型糖尿病的新型药物也越来越受到关注。此类药物能够促进内源胰岛素的分泌, 抑制胰高血糖素的分泌, 同时还可延缓胃排空时间、增加饱腹感、降低食欲, 从而有效地降低餐后血糖, 其与胰岛素联合应用, 可扬长避短, 发挥协同互补的作用, 同时降低低血糖风险。从用药前后糖化血红蛋白的变化和低血糖的发生率方面论述GLP-1RA和DPP-4I对胰岛素血糖控制不良的2型糖尿病患者的有效性和安全性，以期为临床治疗提供参考。
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| 关 键 词： | 2型糖尿病 胰高血糖素样肽-1 二肽基肽酶-4 胰岛素 |
Addition of exenatide twice daily to basal insulin for the treatment of type 2 diabetes |
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| DAI Danping, WU Mei. Research Progress in Effectiveness and Hypoglycemic Risk of Insulin Combined with Incretin Mimetics[J]. Progress in Pharmaceutical Sciences, 2018, 42(8): 622-626. |
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| Authors: | DAI Danping WU Mei |
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| Affiliation: | 1.Department of Pharmacy, The Affiliated Hospital of Medical School, Ningbo University, Ningbo 315020, China |
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| Abstract: | Insulin treatment can improve utilization of peripheral glucose, reduce hepatic glycogen output and effectively lower fasting blood glucose, but it can also cause hypoglycemia, insulin resistance and other adverse reactions. Glucagon-like peptide-1 receptor agonists (GLP-1RA) and dipeptidyl peptidase-4 inhibitors (DPP-4I), as new drugs for treatment of type 2 diabetes, have attracted more and more attention. These drugs can promote secretion of endogenous insulin, suppress secretion of glucagon, delay gastric emptying, increase satiety, reduce appetite, and effectively lower postprandial blood glucose. Combination of these drugs with insulin can maximize their strength and minimize their weakness, give play to synergic complementation, and mitigate the risk of hypoglycemia. Based on glycosylate hemoglobin variation before and after drug administration as well as incidence of hypoglycemia, this paper discussed the effectiveness and safety of GLP-1RA and DPP-4I in type 2 diabetic patients suffering poor glucose control with insulin, hoping to provide reference for clinical practice. |
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| Keywords: | type 2 diabetes glucagon-like peptide-1 dipeptidyl peptidase-4 insulin |
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