老年2型糖尿病患者围术期中甘精胰岛素的应用

目的 探讨老年2型糖尿病患者在围术期采用甘精胰岛素的临床疗效. 方法 将61例围术期老年2型糖尿病患者分为3组,分别采用甘精胰岛素皮下注射降糖治疗、胰岛素泵给予基础量降糖治疗和静脉胰岛素输注降糖治疗;比较治疗后3组控制血糖时间、日平均血糖、血糖波动程度、胰岛素日用量、低血糖发生率、日平均费用. 结果 甘精胰岛素组与胰岛素泵组在控制血糖时间、日平均血糖、胰岛素日用量、低血糖发生率及血糖波动程度等方面无显著性差异(P＞0.05),但均显著低于静脉胰岛素输注组(P＜0.05).甘精胰岛素组在降血糖的日平均费用上显著低于胰岛素泵组(P＜0.05). 结论 老年2型糖尿病患者在围术期应用甘精胰岛素治疗其疗效及安全性与应用胰岛素泵治疗相似,但治疗费用明显低于胰岛素泵.     

Lipid changes during basal insulin peglispro,insulin glargine,or NPH treatment in six IMAGINE trials

Basal insulin peglispro (BIL) is a novel basal insulin with hepato‐preferential action resulting from reduced peripheral effects. This report provides an integrated summary of lipid changes at 26 weeks with BIL and comparator insulins (glargine, NPH) from phase III studies in type 1 diabetes (T1D), insulin‐naïve patients with type 2 diabetes (T2D), patients with T2D on basal insulin only and patients with T2D on basal‐bolus therapy. BIL treatment had little effect on HDL cholesterol and LDL cholesterol in all patients. The effect of both BIL and glargine treatment on triglycerides (TG) depended on whether patients had been previously treated with insulin. When BIL replaced conventional insulin glargine or NPH treatments, increases in TG levels were observed. When BIL or comparator insulins were given for 26 weeks to insulin‐naïve patients with T2D, TG levels were unchanged from baseline with BIL but decreased with either glargine or NPH. The decreased peripheral action of BIL may reduce suppression of lipolysis in peripheral adipose tissue resulting in increased free fatty acid delivery to the liver and, hence, increased hepatic TG synthesis and secretion.     

Effect of exenatide QW or placebo,both added to titrated insulin glargine,in uncontrolled type 2 diabetes: The DURATION‐7 randomized study

Aims

To compare the efficacy and safety of adding the glucagon‐like peptide‐1 receptor agonist exenatide once weekly (QW) 2 mg or placebo among patients with type 2 diabetes who were inadequately controlled despite titrated insulin glargine (IG) ± metformin.

Methods

This multicentre, double‐blind study ( ClinicalTrials.gov identifier: NCT02229383) randomized (1:1) patients with persistent hyperglycaemia after an 8‐week titration phase (glycated haemoglobin [HbA1c] 7.0%‐10.5% [53‐91 mmol/mol]) to exenatide QW or placebo. The primary endpoint was HbA1c change from baseline to week 28. Secondary endpoints included body weight, 2‐hour postprandial glucose, and mean daily IG dose.

Results

Of 464 randomized patients (mean: age, 58 years; HbA1c, 8.5% [69 mmol/mol]; diabetes duration, 11.3 years), 91% completed 28 weeks. Exenatide QW + IG vs placebo + IG significantly reduced HbA1c (least‐squares mean difference, ?0.73% [?8.0 mmol/mol]; 95% confidence interval, ?0.93%, ?0.53% [?10.2, ?5.8 mmol/mol]; P < .001; final HbA1c, 7.55% [59 mmol/mol] and 8.24% [67 mmol/mol], respectively); body weight (?1.50 kg; ?2.17, ?0.84; P < .001); and 2‐hour postprandial glucose (?1.52 mmol/L [?27.5 mg/dL]; ?2.15, ?0.90 [?38.7, ?16.2]; P < .001). Significantly more exenatide QW + IG‐treated patients vs placebo + IG‐treated patients reached HbA1c <7.0% (<53 mmol/mol) (32.5% vs 7.4%; P < .001); daily IG dose increased by 2 and 4 units, respectively. Gastrointestinal and injection‐site adverse events were more frequent with exenatide QW + IG (15.1% and 7.8%, respectively) than with placebo + IG (10.8% and 3.0%, respectively); hypoglycaemia incidence was similar between the exenatide QW + IG (29.7%) and placebo + IG (29.0%) groups, with no major hypoglycaemic events.

Conclusions

Among patients with inadequate glycaemic control, exenatide QW significantly improved glucose control and decreased body weight, without increased hypoglycaemia or unexpected safety findings.     

在2型糖尿病治疗中甘精胰岛素联合瑞格列奈的应用安全性分析

目的 评价对2型糖尿病患者应用甘精胰岛素联合瑞格列奈的临床价值以及安全性分析.方法 选取时间为2017年9月—2019年4月,对该医院收治的138例2型糖尿病患者开展研究,采用数字随机表法将其平均分成2组(实验组与参照组),每组69例.其中参照组运用诺和灵30R治疗,实验组运用甘精胰岛素联合瑞格列奈治疗.对其治疗前后血...     

乳酸菌阴道胶囊辅助甘精胰岛素治疗2型糖尿病合并阴道炎的临床疗效及对预后的影响

目的 研究2型糖尿病合并阴道炎患者通过乳酸菌阴道胶囊辅助甘精胰岛素治疗的效果及对预后的影响.方法 抽取该院于2018年1月—2020年1月内就诊的2型糖尿病合并阴道炎患者共86例,将其依循双盲随机法分为对照组(43例,采用单纯甘精胰岛素治疗方式)与观察组(43例,采用乳酸菌阴道胶囊辅助甘精胰岛素治疗方式),研究比对患者...     

62例老年糖尿病患者采用甘精胰岛素联合阿卡波糖治疗的效果探讨

目的 对甘精胰岛素联合阿卡波糖治疗老年糖尿病患者的效果进行探究.方法 选择该院收治的老年糖尿病患者124例作为该次研究纳入的研究对象,选取时间段为2018年11月—2019年8月,按照随机数表法将其划分为常规组和联合组,每组62例.采用阿卡波糖对常规组进行治疗,在常规组的基础之上,联合甘精胰岛素对联合组患者进行治疗,对...     

小儿Ⅰ型糖尿病应用门冬胰岛素与甘精胰岛素联合治疗的效果

目的探究小儿Ⅰ型糖尿病联合应用门冬胰岛素与甘精胰岛素的治疗效果。方法选取2018年1—12月该院收治的86例小儿Ⅰ型糖尿病患儿,将患儿随机分为单纯1组和联合2组,每组43例。联合2组给予门冬胰岛素+甘精胰岛素治疗;单纯1组给予门冬胰岛素治疗。比较两组血糖水平、低血糖发生率、胰岛素用量及治疗满意度。结果治疗前,两组血糖水平比较差异无统计学意义(P>0.05);治疗后,联合2组血糖水平低于单纯1组,胰岛素用量低于单纯1组,联合2组治疗满意度高于单纯1组,差异有统计学意义(P<0.05)。结论若患有小儿Ⅰ型糖尿病,则使用门冬胰岛素+甘精胰岛素治疗,效果显著,有利控制患儿血糖评分,同时降低低血糖发生率以及胰岛素用量,提高治疗满意度,可临床推广应用。     

A narrative review of approved and emerging anti-obesity medications

BackgroundRecently, many drugs have been approved for halting overweight and obesity—few types of research shifted to using Anti-obesity medications (AOM) solely for well-being and shape-keeping.ObjectiveThis narrative review's objective was to explore the use of AOM in relation to their medical indications, efficacy, and cardiovascular safety.Methods and materialsWe have conducted a narrative review of the literature on approved/non-approved AOM used for obesity and overweight. We have shed light on the emerging trials of therapies and evolving remedies.ResultsRecently, there has been an enormous change in the use of AOM with high consumption that deserves extensive surveillance for the long-term consequences and impact on social, mental, and physical health. Nearly six AOMs and combined therapy are approved by the Food and Drug Administration. The recent guidelines for obesity management have shifted the focus from weight loss to goals that the patient considers essential and toward targeting the root cause of obesity.ConclusionThe use of AOM increased enormously despite its sometimes-dubious safety and ineffectiveness. The public and medical professionals should be vigilant to the real-world benefits of anti-obesity drugs and their achieved effectiveness with an improved safety profile.