The role of GLP-1 mimetics and basal insulin analogues in type 2 diabetes mellitus: guidance from studies of liraglutide
The role of GLP-1 mimetics and basal insulin analogues in type 2 diabetes mellitus: guidance from studies of liraglutide
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DOI：
10.1111/j.1463-1326.2011.01523.x
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发表时间：
2012-04-01
影响因子：
5.8
通讯作者：
Barnett, A. H.
中科院分区：
文献类型：
--
作者：
Barnett, A. H.
在2型糖尿病（T2 DM）患者中，肠促胰岛素的作用降低，但最近出现的二肽基肽酶-4抑制剂和胰高血糖素样肽（GLP）-1激动剂/类似物使肠促胰岛素系统的至少部分功能得以恢复，并伴随着血糖控制的改善。两种GLP-1受体激动剂/类似物目前被批准用于治疗T2 DM美塞那肽（Byetta（R），Eli Lilly & Co.，Indianapolis，IN，US）和利拉鲁肽（Victoza（R），Novo Nordisk，Bagsvaerd，丹麦）;艾塞那肽的每周一次制剂（Bydureon（R），Eli Lilly & Co.）也得到了欧洲药品管理局的批准。美国国家健康与临床优化研究所（NICE）最近发布了关于在T2 DM中使用利拉鲁肽的指南，该指南基于利拉鲁肽在糖尿病中的作用和作用（LEAD）III期试验项目的证据，该项目将利拉鲁肽与现有的降糖治疗（如艾塞那肽和甘精胰岛素）进行了比较。LEAD项目报告利拉鲁肽（1.2和1.8 mg）治疗后HbA 1c从0.8%降至1.5%，伴有低血糖发生率较低和体重减轻;副作用主要为胃肠道副作用（例如恶心和腹泻）。根据LEAD研究的结果和NICE建议，利拉鲁肽现在是英国某些患者群体广泛使用的重要治疗方法，包括体重指数（BMI）≥ 35.0 kg/m2的患者和BMI <10.0 kg/m2的患者。
In people with type 2 diabetes mellitus (T2DM), the incretin effect is reduced, but the recent advent of dipeptidyl peptidase-4 inhibitors and glucagon-like peptide (GLP)-1 agonists/analogues has enabled restoration of at least some of the function of the incretin system, with accompanying improvements in glycaemic control. Two GLP-1 receptor agonists/analogues are currently approved for the treatment of T2DMexenatide (Byetta (R), Eli Lilly & Co., Indianapolis, IN, US) and liraglutide (Victoza (R), Novo Nordisk, Bagsvaerd, Denmark); a once-weekly formulation of exenatide (Bydureon (R), Eli Lilly & Co.) has also been approved by the European Medicines Agency. The National Institute for Health and Clinical Excellence (NICE) has recently published guidance on the use of liraglutide in T2DM, based on evidence from the Liraglutide Effect and Action in Diabetes (LEAD) Phase III trial programme, which compared liraglutide with existing glucose-lowering therapies, such as exenatide and insulin glargine. The LEAD programme reported HbA1c reductions from 0.8 to 1.5% with liraglutide (1.2 and 1.8 mg), accompanied by low rates of hypoglycaemia and some weight loss; side effects were primarily gastrointestinal in nature (e.g. nausea and diarrhoea). Based on the findings of the LEAD studies and the NICE recommendation, liraglutide now represents an important therapy widely available in the UK for certain patient groups, including those with a body mass index (BMI) =35.0 kg/m2, and patients with a BMI