JCEM:小剂量胰高血糖素治疗1型糖尿病患者非严重低血糖症的疗效和安全性如何?

2017-06-10 xing.T MedSci原创

低剂量胰高血糖素可以成功地治疗轻度至中度低血糖,并可能是口服碳水化合物的一种有用的替代治疗,尽量避免了不必要的热量摄入。

低血糖症的标准治疗是口服碳水化合物,但往往会导致高血糖,并且需要额外的热量摄入。近日,内分泌和代谢性疾病领域权威杂志Journal of Clinical Endocrinology & Metabolism上发表了一篇研究文章,研究人员旨在评价使用小剂量的胰高血糖素治疗轻度低血糖的成年1型糖尿病患者。

该研究为在五个美国糖尿病诊所进行的随机交叉试验(2-3周)。研究的参与者为20名使用胰岛素泵以及连续血糖监测(CGM)的频繁发生轻度低血糖的1型糖尿病患者。该研究的干预措施为采用非水溶的微量胰高血糖素(MDG)(150µg)治疗非严重低血糖,其主要观察指标为:成功的治疗,其被定义为干预后15分钟血糖≥50毫克/分升,30分钟血糖≥70毫克/分升。有两名对治疗分组不知情的作者独立地判断每个事件的结局,即治疗成功或失败。

该研究纳入了16名受试者(平均年龄为39岁,女性占75%,平均病程为23年,平均HbA1c为7.2%),他们的初始血糖为50毫克/分升,有118次可分析的事件。在MDG期间,62次事件中有58次达到了治疗成功的标准(94%),在葡萄糖快速补充(TABS)期间56次事件中有53(95%)次达到标准(调整后的P=0.99)。这些事件成功的临床评估分别为97%和96%。在事件后2小时期间,CGM为70-180mg/dL的测量时间在治疗组之间没有差异,但在第一个小时中TABS导致了更高的最大血糖(116 vs. 102毫克/分升;P=0.01)。

低剂量胰高血糖素可以成功地治疗轻度至中度低血糖,并可能是口服碳水化合物的一种有用的替代治疗,尽量避免了不必要的热量摄入。

原始出处:

Morey W. Haymond,et al. Efficacy and Safety of Mini-dose Glucagon for Treatment of Non-severe Hypoglycemia in Adults with Type 1 Diabetes. J Clin Endocrinol Metab. 2017. https://doi.org/10.1210/jc.2017-00591

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    2018-03-02 achengzhao
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    2018-05-13 pyaili
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  5. 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  6. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1457611, encodeId=aacc145e611f6, content=<a href='/topic/show?id=72148400568' target=_blank style='color:#2F92EE;'>#胰高血糖素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84005, encryptionId=72148400568, topicName=胰高血糖素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b38f5964248, createdName=sjzlzc009, createdTime=Mon Jun 12 05:26:00 CST 2017, time=2017-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1457795, encodeId=a5bf145e79511, content=<a href='/topic/show?id=b63926366a2' target=_blank style='color:#2F92EE;'>#低血糖症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26366, encryptionId=b63926366a2, topicName=低血糖症)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0b0b5986082, createdName=appleandpeer, createdTime=Mon Jun 12 05:26:00 CST 2017, time=2017-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1474203, encodeId=f36914e420316, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Mon Jun 12 05:26:00 CST 2017, time=2017-06-12, status=1, ipAttribution=)]
    2017-12-26 智智灵药
  7. 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    2017-06-12 hbwxf
  8. 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