PDF(Pubmed)
Abstract：
We evaluated the clinical impact, in daily clinical practice, of sodium-glucose co-transporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP1RA) therapies in patients with type 2 diabetes. Data from 500 unselected consecutive patients were retrospectively analyzed. Only those with a full assessment at baseline (T0) and after 3 (T3), 6 (T6), and 12 (T12) months of treatment with SGLT2i or GLP1RA were included in the study (n = 167). At baseline, patients had a high mean body weight (BW), abdominal circumference (AC), body mass index (BMI), and HOMA index. Despite normal C-peptide values, 39 patients were being treated with insulin (up to 120 IU/day). During therapy, a progressive improvement in BW, BMI, and AC was observed with both the molecules. Fasting glucose and glycated Hb decrease was already significant at T3 in all patients, while the HOMA index selectively improved with SGLT2i therapy. Renal function parameters remained stable regardless of the drug used. Finally, SGLT2i reduced serum uric acid and improved the lipid profile, while GLP1RA reduced serum levels of liver enzymes. Both the therapeutic regimens allowed a significant reduction or complete suspension of unnecessary insulin therapies. Our real life data confirm the results obtained from randomized clinical trials and should be taken as a warning against inappropriate use of insulin in patients with preserved β-cell function.
摘要：
我们评估了临床影响，在日常临床实践中，钠-葡萄糖协同转运蛋白-2抑制剂（SGLT2i）和胰高血糖素样肽-1受体激动剂（GLP1RA）治疗2型糖尿病患者。回顾性分析了500名未选择的连续患者的数据。只有那些在基线(T0)和3(T3)后进行全面评估的人，6(T6),研究包括SGLT2i或GLP1RA治疗12个月(T12)(n=167).在基线,患者平均体重（BW）较高，腹围（AC），体重指数（BMI），HOMA指数。尽管C肽值正常，39名患者正在接受胰岛素治疗（高达120IU/天）。在治疗期间,BW的逐步提高，BMI,这两种分子都观察到了AC。空腹血糖和糖化血红蛋白下降在所有患者的T3已经显著，而SGLT2i治疗后HOMA指数选择性改善。无论使用何种药物，肾功能参数均保持稳定。最后,SGLT2i降低血清尿酸，改善血脂，而GLP1RA降低血清肝酶水平。两种治疗方案都允许显著减少或完全中止不必要的胰岛素治疗。我们的现实生活数据证实了从随机临床试验中获得的结果，应作为对β细胞功能保留的患者不适当使用胰岛素的警告。
