JCEM:SGLT2抑制剂增加了糖尿病酮症酸中毒的风险

2019-03-06 xing.T 网络

由此可见,与非SGLT2i服用者相比,住院的SGLT2i服用者更有可能发生DKA。SGLT2i的使用与DKA的风险显著增加相关。

糖尿病酮症酸中毒(DKA)与使用钠葡萄糖协同转运蛋白2抑制剂(SGLT2i)有关。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,该研究旨在确定SGLT2i服用者与非2型糖尿病患者DKA的发生率、特征和结局的关系。

该研究为回顾性、多中心、对照队列研究,研究时间为2017年9月1日至2017年10月31日,以澳大利亚墨尔本和吉朗的所有公立医院(合计人口500万)为基础。参与者为连续就诊的在社区或住院期间发生DKA的2型糖尿病患者,主要观察指标为SGLT2i服用者与非服用者比较:(i)住院期间DKA发生的比值比和(ii)DKA发病率。

该研究共有162例DKA患者(37例SGLT2i服用者和125例非SGLT2i服用者),经医生判定为2型糖尿病。其中,14名(38%)SGLT2i服用者和2名(2%)非SGLT2i服用者在住院期间发生了DKA(比值比为37.4 [95%CI为8.0-175.9],p<0.0001)。 SGLT2i服用者中糖尿病酮症酸中毒的发生率为1.02人/1000人(95%CI为0.74-1.41/1000),而非SGLT2i服用者为0.69人/1000人(0.58-0.82/1000)(比值比为1.48(1.02-2.15),p=0.037)。与1名(0.8%)非SGLT2i服用者相比,15名SGLT2i服用者(41%)血糖峰值<250mg/dl(14mmol/l)(p<0.001)。

由此可见,与非SGLT2i服用者相比,住院的SGLT2i服用者更有可能发生DKA。SGLT2i的使用与DKA的风险显著增加相关。

原始出处:

Peter S Hamblin.et al.SGLT2 Inhibitors Increase the Risk of Diabetic Ketoacidosis Developing in the Community and During Hospital Admission.J Clin Endocrinol Metab. 2019.https://doi.org/10.1210/jc.2019-00139

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    2019-03-08 tulenzi
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    2019-04-27 jklm09
  4. 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href='/topic/show?id=eb9610265ed' target=_blank style='color:#2F92EE;'>#JCEM#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10265, encryptionId=eb9610265ed, topicName=JCEM)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2a4439169927, createdName=smallant2015, createdTime=Fri Apr 26 05:14:00 CST 2019, time=2019-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1288687, encodeId=bab5128868e15, content=<a href='/topic/show?id=b969e679974' target=_blank style='color:#2F92EE;'>#糖尿病酮症酸中毒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76799, encryptionId=b969e679974, topicName=糖尿病酮症酸中毒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8346212, createdName=respect, createdTime=Fri Mar 08 07:14:00 CST 2019, time=2019-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1319108, encodeId=8af41319108b9, content=<a href='/topic/show?id=14d92231508' target=_blank style='color:#2F92EE;'>#中毒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22315, encryptionId=14d92231508, topicName=中毒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f13d475, createdName=mashirong, createdTime=Fri Mar 08 07:14:00 CST 2019, time=2019-03-08, status=1, ipAttribution=)]
    2019-08-17 achengzhao
  5. 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time=2019-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1319108, encodeId=8af41319108b9, content=<a href='/topic/show?id=14d92231508' target=_blank style='color:#2F92EE;'>#中毒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22315, encryptionId=14d92231508, topicName=中毒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f13d475, createdName=mashirong, createdTime=Fri Mar 08 07:14:00 CST 2019, time=2019-03-08, status=1, ipAttribution=)]
  6. 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  7. 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    2019-04-26 smallant2015
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    2019-03-08 mashirong

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由此可见,在对来自两个国家的全国性登记的分析中,与GLP1受体激动剂相比,使用SGLT2抑制剂与下肢截肢和糖尿病酮症酸中毒的风险增加相关,但与当前关注的其它严重不良事件无关。

Lancet diabetes endo:度拉糖肽作为SGLT2抑制剂的补充治疗,用于血糖控制效果欠佳的2型糖尿病患者的效果和安全性

GLP-1受体兴奋剂和钠-葡萄糖共转运体-2(SGLT2)抑制剂可通过不同的机制改善2型糖尿病患者的血糖控制,并减轻其体重。近日,Lancet子刊上发表一篇文章,对采用SGLT2抑制剂治疗(联合或未联合二甲双胍)未能很好的控制血糖的2型糖尿病患者,每周补充一次GLP-1受体兴奋剂度拉糖肽(dulaglutide)的疗效和安全性进行评估。研究人员在多个国家的40个临床中心进行一双盲、平行臂、安慰剂为