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Elevated urinary albumin predicts increased time in range after initiation of SGLT2 inhibitors in individuals with type 1 diabetes on sensor-augmented pump therapy. 尿白蛋白升高可预测接受传感器增强泵治疗的 1 型糖尿病患者在开始使用 SGLT2 抑制剂后进入量程的时间延长。
IF 1.3 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-06 eCollection Date: 2024-10-01 DOI: 10.1007/s13340-024-00743-4
Yuka Suganuma, Mizuki Ishiguro, Takayuki Ohno, Rimei Nishimura

Aims: We aimed to investigate potential predictors of effectiveness of SGLT2 inhibitors (SGLT2i) in individuals with type 1 diabetes (T1D) on sensor-augmented pump (SAP) therapy.

Methods: We included individuals with T1D receiving SAP therapy at our hospital who were newly initiated on SGLT2i between 2019 and 2020 and were followed for at least 1 year. Data on BMI, blood tests, and continuous glucose monitoring (CGM) were compared before and 12 months after initiation of SGLT2i. Predictors of incremental increases in time in range (ΔTIR) were explored using a multiple regression analysis. Cutoff values for the predictors were determined using an ROC curve analysis.

Results: A total of 17 individuals (females, 70.6%; median age, 44.0 years) were included, excluding three individuals who discontinued SGLT2i due to side effects. During follow-up, their median BMI decreased significantly (P = 0.013), while no significant change was seen in their total daily dose of insulin, basal-to-total insulin ratio. Again, their HbA1c, TIR, and time above range (TAR) improved significantly (P = 0.004, P = 0.003, and P = 0.003, respectively), while their time below range (TBR) showed no significant change. The predictor of increased ΔTIR was high urinary albumin-to-creatinine ratio (UACR) at baseline (P = 0.026) only, with the cutoff value determined to be 28.0 mg/g Cr or higher (AUC = 0.82, P = 0.003).

Conclusions: It may be suggested that individuals with T1D on SAP therapy and having near-microalbuminuria or higher could be expected to show significant improvement in TIR.

Supplementary information: The online version contains supplementary material available at 10.1007/s13340-024-00743-4.

目的:我们旨在研究SGLT2抑制剂(SGLT2i)对接受传感器增强泵(SAP)治疗的1型糖尿病(T1D)患者疗效的潜在预测因素:我们纳入了在本医院接受SAP治疗的T1D患者,他们在2019年至2020年间新开始使用SGLT2i,并接受了至少1年的随访。比较了开始使用 SGLT2i 之前和之后 12 个月的 BMI、血液化验和连续血糖监测(CGM)数据。采用多元回归分析探讨了在量程内时间(ΔTIR)递增的预测因素。通过 ROC 曲线分析确定了预测因素的临界值:共纳入 17 人(女性,70.6%;中位年龄,44.0 岁),其中不包括因副作用停用 SGLT2i 的 3 人。在随访期间,他们的中位体重指数显著下降(P = 0.013),而每日胰岛素总剂量、基础胰岛素与总胰岛素之比没有显著变化。同样,他们的 HbA1c、TIR 和高于量程的时间(TAR)也有明显改善(分别为 P = 0.004、P = 0.003 和 P = 0.003),而低于量程的时间(TBR)则无明显变化。预测ΔTIR升高的因素仅是基线时尿白蛋白与肌酐比值(UACR)偏高(P = 0.026),其临界值被确定为 28.0 mg/g Cr 或更高(AUC = 0.82,P = 0.003):结论:可以认为,接受SAP治疗的T1D患者,如果有近微量白蛋白尿或更高,TIR有望得到显著改善:在线版本包含补充材料,可在10.1007/s13340-024-00743-4上查阅。
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引用次数: 0
Correction: Mortality in childhood-onset type 1 diabetes mellitus with onset between 1959 and 1996: A population-based study in Hokkaido, Japan. 更正:1959年至1996年间发病的儿童型1型糖尿病患者的死亡率:日本北海道人口研究。
IF 1.3 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-06 eCollection Date: 2024-10-01 DOI: 10.1007/s13340-024-00740-7
Nobuo Matsuura, Hiroshi Yokomichi, Yoshiya Ito, Shigeru Suzuki, Mie Mochizuki

[This corrects the article DOI: 10.1007/s13340-023-00688-0.].

[此处更正了文章 DOI:10.1007/s13340-023-00688-0]。
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引用次数: 0
Effects of weight loss from oral semaglutide administration on cardiometabolic risk factors in Japanese patients with type 2 diabetes: a retrospective analysis using propensity score matching. 日本 2 型糖尿病患者通过口服塞马鲁肽减轻体重对心脏代谢风险因素的影响:使用倾向得分匹配法进行的回顾性分析。
IF 1.3 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-07-31 eCollection Date: 2024-10-01 DOI: 10.1007/s13340-024-00744-3
Kazuki Aoyama, Yuya Nakajima, Shu Meguro, Kaori Hayashi

Background: Obesity is increasingly being recognized as a chronic disease that exacerbates type 2 diabetes and its related complications. Oral semaglutide, a novel glucagon-like peptide-1 (GLP-1) receptor agonist, has demonstrated efficacy in weight loss and diabetes control in Western populations. However, in real-world clinical practice, its effectiveness in Japanese patients, who typically exhibit a leaner phenotype and unique genetic susceptibilities affecting insulin secretion, remains unclear.

Methods: We retrospectively evaluated the electronic medical records of 313 patients treated with oral semaglutide and 11,239 untreated controls at the Keio University School of Medicine. We performed propensity score matching to adjust for covariates, including age, sex, height, weight, blood pressure, blood test data, medications, and compared the cardiometabolic risk factors, including HbA1c, blood pressure, lipids, and liver function 180 days post-treatment, of both patient groups. We conducted a subgroup analysis for patients who achieved ≥ 3% weight loss.

Results: After propensity score matching, the semaglutide group demonstrated significantly better outcomes for HbA1c reduction and weight loss and improvements in systolic blood pressure (SBP), low-density lipoprotein cholesterol (LDL-C), and liver function than the control group. Subgroup analysis of patients with ≥ 3% weight loss revealed superior HbA1c improvements in the semaglutide group; however, no significant differences in other metabolic parameters, such as SBP, LDL-C, and liver function, were observed.

Conclusion: Oral semaglutide effectively improved metabolic markers in Japanese patients with type 2 diabetes, similar to that in Western populations. Weight loss itself was suggested to significantly contribute to blood pressure, lipid levels, and liver function changes.

Supplementary information: The online version contains supplementary material available at 10.1007/s13340-024-00744-3.

背景:人们日益认识到肥胖是一种慢性疾病,会加剧 2 型糖尿病及其相关并发症。口服塞马鲁肽是一种新型胰高血糖素样肽-1(GLP-1)受体激动剂,已在西方人群中证实具有减轻体重和控制糖尿病的功效。然而,在现实世界的临床实践中,该药对日本患者的疗效仍不明确,因为日本患者通常表现出较瘦弱的表型和影响胰岛素分泌的独特遗传易感性:我们回顾性评估了庆应义塾大学医学院 313 名接受口服塞马鲁肽治疗的患者和 11,239 名未接受治疗的对照组患者的电子病历。我们对两组患者的协变量(包括年龄、性别、身高、体重、血压、血液检测数据、药物)进行了倾向得分匹配调整,并比较了两组患者治疗后 180 天的心血管代谢风险因素(包括 HbA1c、血压、血脂和肝功能)。我们对体重减轻≥3%的患者进行了亚组分析:经过倾向评分匹配后,与对照组相比,塞马鲁肽组在降低 HbA1c、减轻体重以及改善收缩压 (SBP)、低密度脂蛋白胆固醇 (LDL-C) 和肝功能方面的效果明显更好。对体重减轻≥3%的患者进行的亚组分析表明,在改善HbA1c方面,塞马鲁肽组更胜一筹;然而,在其他代谢指标(如SBP、低密度脂蛋白胆固醇和肝功能)方面,未观察到显著差异:结论:口服塞马鲁肽能有效改善日本 2 型糖尿病患者的代谢指标,这与西方人群的情况类似。结论:口服塞马鲁肽能有效改善日本 2 型糖尿病患者的代谢指标,与西方人群相似。减重本身被认为对血压、血脂水平和肝功能的变化有显著促进作用:在线版本包含补充材料,可在 10.1007/s13340-024-00744-3上查阅。
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引用次数: 0
A case of Cushing's syndrome in a pregnant woman associated with hypertension, hypokalemia, and gestational diabetes mellitus. 一例伴有高血压、低钾血症和妊娠糖尿病的孕妇库欣综合征。
IF 1.3 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-07-23 eCollection Date: 2024-10-01 DOI: 10.1007/s13340-024-00745-2
Hajime Sugawara, Norio Wada, Shuhei Baba, Arina Miyoshi, Shinji Obara, Yuto Yamazaki, Hironobu Sasano

We report the case of a 33-year-old woman who was referred to the department of endocrinology and diagnosed with gestational diabetes mellitus (GDM). She had been hypertensive from 20 weeks of pregnancy. A 75 g oral glucose tolerance test for screening of GDM at 26 weeks of pregnancy revealed positive results at two points: 183 mg/dL at 60 min, and 193 mg/dL at 90 min. At the first visit to the Department of Endocrinology, Cushing's features were clinically unclear. She started self-monitoring blood glucose levels, and hypokalemia was detected. At 28 weeks of pregnancy, she was admitted to our hospital because of uncontrolled blood pressure. The patient started multiple injections of rapid insulin for postprandial hyperglycemia. Laboratory testing revealed suppressed plasma ACTH (< 1.5 pg/mL) and elevated serum cortisol levels (34.1 μg/dL) in the early morning. Because of uncontrollable pregnancy related complications, the patient delivered a baby by Caesarean section at 29 weeks of pregnancy. After delivery, she was diagnosed with ACTH-independent Cushing's syndrome by endocrinological tests. Computed tomography scan demonstrated a right adrenal tumor measuring 24 mm at greatest dimension. Twenty-three days after delivery, laparoscopic right adrenalectomy was performed. The diagnosis of cortisol-producing adrenocortical adenoma was pathologically confirmed. After surgery, the patient was given glucocorticoids as a replacement, and her blood pressure, blood glucose, and serum potassium levels were normalized. Although rare, GDM may be caused by Cushing's syndrome. Pregnant women with combinations of GDM, hypertension, and hypokalemia should be clinically suspected as harboring Cushing's syndrome even in the absence of specific clinical features.

我们报告了一例转诊至内分泌科并被诊断为妊娠糖尿病(GDM)的 33 岁女性病例。她从怀孕 20 周起就一直患有高血压。在怀孕 26 周时,为筛查 GDM 而进行了 75 克口服葡萄糖耐量试验,结果在两个时间点呈阳性:60 分钟时为 183 毫克/分升,90 分钟时为 193 毫克/分升。首次到内分泌科就诊时,库欣病的临床特征并不明确。她开始自我监测血糖水平,并发现了低钾血症。怀孕 28 周时,她因血压无法控制而住进了我院。患者开始多次注射快速胰岛素治疗餐后高血糖。实验室检测显示血浆促肾上腺皮质激素(ACTH)(≥1.5μg/ml)受到抑制。
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引用次数: 0
Natural biopolymer-based hydrogels: an advanced material for diabetic wound healing. 天然生物聚合物水凝胶:糖尿病伤口愈合的先进材料。
IF 1.3 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-06-26 eCollection Date: 2024-10-01 DOI: 10.1007/s13340-024-00737-2
Arunim, Sarita, Rakesh Mishra, Surabhi Bajpai

A diabetic foot ulcer (DFU) is an open sore or wound that typically develops on the bottom of the foot. Almost 15% of people with diabetes are suffering from delayed wound healing worldwide. The main vehicle for the development of ulcers in the diabetic population is poor circulation and peripheral neuropathy. Chronic injuries from diabetes frequently lead to traumatic lower leg amputations. Hydrogels are three-dimensional gels that can be fabricated from natural polymers and synthetic polymers. Biopolymers are flexible, elastic, or fibrous materials that come from a natural source, such as plants, animals, bacteria, or other living things. Some of the naturally occurring polymers that are frequently employed in wound dressing applications include polysaccharides and proteins. These polymers can be employed for many therapeutic applications because of their inherent biocompatibility, low immunogenicity, non-toxicity, and biodegradability. They represent a tuneable platform for enhancing skin healing. Therefore, this review paper interprets how natural biopolymers and their various hydrogel forms can be potentially used for diabetic wound healing.

糖尿病足溃疡(DFU)是一种开放性溃疡或伤口,通常发生在足底部。全世界有近 15%的糖尿病患者患有伤口愈合延迟症。糖尿病患者出现溃疡的主要原因是血液循环不良和周围神经病变。糖尿病引起的慢性损伤经常导致小腿创伤性截肢。水凝胶是一种三维凝胶,可由天然聚合物和合成聚合物制成。生物聚合物是一种柔韧、有弹性或纤维状的材料,来源于自然界,如植物、动物、细菌或其他生物。伤口敷料中经常使用的天然聚合物包括多糖和蛋白质。这些聚合物具有固有的生物相容性、低免疫原性、无毒性和生物可降解性,因此可用于多种治疗用途。它们是一个可调整的平台,可用于提高皮肤愈合能力。因此,本综述论文阐述了天然生物聚合物及其各种水凝胶形式可如何潜在地用于糖尿病伤口愈合。
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引用次数: 0
Healthy lifestyle factors as predictors of the initiation of dialysis in people with and without diabetes. 健康生活方式是糖尿病患者和非糖尿病患者开始透析的预测因素。
IF 1.3 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-06-25 eCollection Date: 2024-10-01 DOI: 10.1007/s13340-024-00739-0
Taeko Osawa, Kazuya Fujihara, Mayuko Harada Yamada, Yuta Yaguchi, Takaaki Sato, Masaru Kitazawa, Yasuhiro Matsubayashi, Takaho Yamada, Satoru Kodama, Hirohito Sone

Aims: To clarify the impact of Breslow's scores consisting of only lifestyle habits or American Heart Association's (AHA) Life's Simple 7 scores consisting of lifestyle habits and control targets on starting dialysis in people with or without diabetes mellitus (DM).

Methods: To pursue the study aims, we examined a nationwide database on 294,647 individuals with and without DM aged 19-72 y in Japan to pursue the study aims. Using multivariate Cox modeling, we evaluated and compared 5 risk factors based on the unfavorable lifestyle factors in Breslow's scores and the unfavorable lifestyle factors and clinical values in AHA Life's Simple 7 scores.

Results: DM increased the risk of the initiation of dialysis 5- to sixfold but that risk did not increase with worsening of Breslow risk factors. Compared with no risk factor, 5 risk factors derived from AHA's Life's Simple 7 presented 9.8-fold and 4.2-fold risks for the initiation of dialysis in non-DM and DM, respectively. In comparison with non-DM and no risk factor, risk of the initiation of dialysis dramatically increased up to 32.3 times according to the number of AHA risk factors in those with DM.

Conclusions: DM and risk factors derived from AHA's Life's Simple 7 synergistically increased the risk of the initiation of dialysis. Factors similar to those used to predict cardiovascular disease would also be useful to predict the initiation of dialysis. These approaches might be helpful in clinical practice and patient education.

Supplementary information: The online version contains supplementary material available at 10.1007/s13340-024-00739-0.

目的:阐明仅包含生活习惯的布雷斯罗评分或包含生活习惯和控制目标的美国心脏协会(AHA)"生活简单 7 "评分对糖尿病(DM)患者或非糖尿病患者开始透析的影响:为了实现研究目的,我们对日本全国范围内 294,647 名年龄在 19-72 岁之间的糖尿病患者和非糖尿病患者的数据库进行了研究。通过多变量 Cox 模型,我们评估并比较了基于布雷斯罗评分中的不利生活方式因素和 AHA 生活简易 7 评分中的不利生活方式因素和临床价值的 5 个风险因素:糖尿病会使开始透析的风险增加 5 到 6 倍,但这种风险不会随着布雷斯罗风险因素的恶化而增加。与无风险因素相比,根据美国心脏协会生命简易7级评分得出的5个风险因素在非DM和DM患者中引发透析的风险分别为9.8倍和4.2倍。与非DM和无危险因素者相比,DM患者开始透析的风险根据AHA危险因素的数量急剧增加,最高可达32.3倍:结论:DM和从AHA的 "生命之简7 "中得出的风险因素会协同增加开始透析的风险。与用于预测心血管疾病的因素类似,这些因素也有助于预测开始透析的风险。这些方法可能有助于临床实践和患者教育:在线版本包含补充材料,可在 10.1007/s13340-024-00739-0上查阅。
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引用次数: 0
mTORC1 signaling and diabetic kidney disease. mTORC1 信号传导与糖尿病肾病。
IF 1.3 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-06-20 eCollection Date: 2024-10-01 DOI: 10.1007/s13340-024-00738-1
Vinamra Swaroop, Eden Ozkan, Lydia Herrmann, Aaron Thurman, Olivia Kopasz-Gemmen, Abhiram Kunamneni, Ken Inoki

Diabetic kidney disease (DKD) represents the most lethal complication in both type 1 and type 2 diabetes. The disease progresses without obvious symptoms and is often refractory when apparent symptoms have emerged. Although the molecular mechanisms underlying the onset/progression of DKD have been extensively studied, only a few effective therapies are currently available. Pathogenesis of DKD involves multifaced events caused by diabetes, which include alterations of metabolisms, signals, and hemodynamics. While the considerable efficacy of sodium/glucose cotransporter-2 (SGLT2) inhibitors or angiotensin II receptor blockers (ARBs) for DKD has been recognized, the ever-increasing number of patients with diabetes and DKD warrants additional practical therapeutic approaches that prevent DKD from diabetes. One plausible but promising target is the mechanistic target of the rapamycin complex 1 (mTORC1) signaling pathway, which senses cellular nutrients to control various anabolic and catabolic processes. This review introduces the current understanding of the mTOR signaling pathway and its roles in the development of DKD and other chronic kidney diseases (CKDs), and discusses potential therapeutic approaches targeting this pathway for the future treatment of DKD.

糖尿病肾病(DKD)是 1 型和 2 型糖尿病最致命的并发症。这种疾病在没有明显症状的情况下发展,而且在出现明显症状时往往是难治性的。尽管对 DKD 发病/进展的分子机制进行了广泛研究,但目前只有少数几种有效疗法。DKD 的发病机制涉及糖尿病引起的多方面事件,包括代谢、信号和血液动力学的改变。虽然钠/葡萄糖共转运体-2(SGLT2)抑制剂或血管紧张素 II 受体阻滞剂(ARB)对 DKD 的疗效已得到认可,但糖尿病和 DKD 患者人数的不断增加需要更多实用的治疗方法,以防止 DKD 从糖尿病发展为 DKD。雷帕霉素复合体 1(mTORC1)信号通路是一个看似合理但很有前景的靶点,它能感知细胞营养物质,控制各种合成代谢和分解代谢过程。这篇综述介绍了目前对mTOR信号通路的理解及其在DKD和其他慢性肾脏疾病(CKD)发展过程中的作用,并讨论了针对这一通路的潜在治疗方法,以便在未来治疗DKD。
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引用次数: 0
Advances in glucagon research ~ 100th anniversary: invitation to the new 'glucagon-ology'. 胰高血糖素研究进展 ~ 100 周年:新 "胰高血糖素学 "邀请函。
IF 1.3 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-05-31 eCollection Date: 2024-07-01 DOI: 10.1007/s13340-024-00728-3
Dan Kawamori
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引用次数: 0
Case of new-onset fulminant type 1 diabetes mellitus accompanied by autoimmune thyroid disease after SARS-CoV-2 infection. 感染SARS-CoV-2后新发暴发性1型糖尿病并伴有自身免疫性甲状腺疾病的病例。
IF 1.3 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-05-30 eCollection Date: 2024-07-01 DOI: 10.1007/s13340-024-00729-2
Keisuke Murakawa, Hiroaki Aasi, Kanako Sato, Saori Yoshioka, Hiroyuki Sho, Ryoko Inui, Motohiro Kosugi, Yoji Hazama, Tetsuyuki Yasuda

There is growing evidence suggesting an association between severe acute respiratory coronavirus syndrome coronavirus 2 (SARS-CoV-2) infection and various extrapulmonary diseases since the advent of coronavirus disease 2019 (COVID-19) pandemic. However, case reports of fulminant type 1 diabetes mellitus (FT1D) following SARS-CoV-2 infection are limited. We encountered a 44-year-old Japanese woman who developed FT1D accompanied by subclinical thyrotoxicosis caused by autoimmune thyroid disease (AITD) approximately one week after SARS-CoV-2 infection. The patient developed fever and flu-like symptom 4 days before transportation and tested positive then for the SARS-CoV-2 antigen self-test. She subsequently developed sudden thirst, polyuria, and fatigue of 1 day duration and was urgently brought to our emergency room. Laboratory findings indicated diabetic ketoacidosis (DKA) without marked elevation of serum glycated hemoglobin (HbA1c) levels (glucose, 930 mg/dL; HbA1c, 7.4%). Her insulin secretory capacity was almost completely depleted, and islet-specific autoantibodies were negative. Endocrine examinations revealed subclinical thyrotoxicosis, which was positive for thyroid stimulation hormone receptor antibodies. Based on these results, the patient was diagnosed with FT1D accompanied by AITD and immediately started on intensive insulin therapy with a basal-bolus subcutaneous insulin regimen. Human leukocyte antigen analysis revealed haplotypes, indicating susceptibility to both FT1D and AITD. Further studies are required to elucidate the causal relationship between SARS-CoV-2 infection, FT1D, and AITD. However, clinicians must be vigilant about possible development of FT1D and AITD to enable accurate diagnosis and treatment of patients with DKA during the COVID-19 pandemic.

自 2019 年冠状病毒病(COVID-19)大流行以来,越来越多的证据表明严重急性呼吸道冠状病毒综合征冠状病毒 2(SARS-CoV-2)感染与各种肺外疾病之间存在关联。然而,SARS-CoV-2 感染后引发暴发性 1 型糖尿病(FT1D)的病例报告却非常有限。我们遇到了一名 44 岁的日本女性,她在感染 SARS-CoV-2 约一周后出现 FT1D,并伴有自身免疫性甲状腺疾病(AITD)引起的亚临床甲状腺毒症。患者在转运前 4 天出现发热和流感样症状,SARS-CoV-2 抗原自我检测呈阳性。随后,她突然出现口渴、多尿和乏力,持续了 1 天,被紧急送到我们的急诊室。实验室检查结果显示她患有糖尿病酮症酸中毒(DKA),但血清糖化血红蛋白(HbA1c)水平没有明显升高(葡萄糖,930 毫克/分升;HbA1c,7.4%)。她的胰岛素分泌能力几乎完全丧失,胰岛特异性自身抗体呈阴性。内分泌检查发现了亚临床甲状腺毒症,甲状腺刺激素受体抗体呈阳性。根据上述结果,患者被诊断为 FT1D 并伴有 AITD,并立即开始接受胰岛素强化治疗,采用基础-注射皮下胰岛素方案。人类白细胞抗原分析显示了单倍型,表明患者对 FT1D 和 AITD 都有易感性。要阐明 SARS-CoV-2 感染、FT1D 和 AITD 之间的因果关系,还需要进一步的研究。然而,临床医生必须对 FT1D 和 AITD 的可能发展保持警惕,以便在 COVID-19 大流行期间准确诊断和治疗 DKA 患者。
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引用次数: 0
Efficacy and safety of switching from a dipeptidyl peptidase-4 inhibitor to oral semaglutide in Japanese patients with type 2 diabetes mellitus. 日本 2 型糖尿病患者从二肽基肽酶-4 抑制剂转为口服塞马鲁肽的疗效和安全性。
IF 1.3 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-05-30 eCollection Date: 2024-07-01 DOI: 10.1007/s13340-024-00734-5
Chihiro Yoneda, Junji Kobayashi, Nobuichi Kuribayashi

Background: Dipeptidyl peptidase-4 inhibitors (DPP-4is) are the most widely used oral hypoglycemic drugs in Japan. However, once-daily oral semaglutide has been reported to reduce glycated hemoglobin (HbA1c) and body weight (BW) without causing significant hypoglycemia. Here, we aimed to evaluate the efficacy and safety of switching from a DPP-4i to oral semaglutide in Japanese patients with type 2 diabetes (T2D).

Methods: We performed a single-center retrospective study of the changes in HbA1c and BW in 68 patients with T2D who were switched from a DPP-4i and took oral semaglutide for  ≥ 6 months, without changes in any other oral hypoglycemic agent.

Results: Mean HbA1c decreased from 7.8 to 7.0% (p < 0.001) and BW decreased from 74.2 to 71.2 kg (p < 0.001) over 6 months. The decrease in HbA1c was more pronounced in participants with high baseline HbA1c (r =  - 0.542, p < 0.001). There was also a trend (r = 0.236, p = 0.052) toward a decrease in BW in individuals with shorter disease duration. There were reductions in either HbA1c or BW in 65 participants (95.6%). In addition, the larger the decrease in HbA1c was, the greater was the decrease in BW (r = 0.480, p < 0.001). Eighteen participants (20.1%) discontinued the drug within 6 months, of whom 10 (11.6% of the total) did so because of suspected adverse effects and the discontinuation rate was the highest in older, non-obese patients.

Conclusions: Switching from a DPP-4i to oral semaglutide may be useful for Japanese patients with T2D who have inadequate glycemic or BW control. However, its utility may be limited by gastrointestinal adverse effects in certain patients.

背景:二肽基肽酶-4 抑制剂(DPP-4is)是日本最广泛使用的口服降糖药。然而,据报道,每日口服一次的塞马鲁肽可降低糖化血红蛋白(HbA1c)和体重(BW),但不会引起明显的低血糖。在此,我们旨在评估日本 2 型糖尿病(T2D)患者从 DPP-4i 转为口服塞马鲁肽的疗效和安全性:我们对68名T2D患者的HbA1c和体重变化进行了单中心回顾性研究,这些患者从DPP-4i转为口服司马鲁肽≥6个月,且未更换任何其他口服降糖药:平均 HbA1c 从 7.8% 降至 7.0%(p p r = - 0.542,p r = 0.236,p = 0.052),病程较短的患者体重有所下降。65 名参与者(95.6%)的 HbA1c 或体重均有所下降。此外,HbA1c 下降幅度越大,体重下降幅度也越大(r = 0.480,p 结论):对于血糖或体重控制不佳的日本 T2D 患者来说,从 DPP-4i 转为口服塞马鲁肽可能会有所帮助。然而,某些患者的胃肠道不良反应可能会限制其效用。
{"title":"Efficacy and safety of switching from a dipeptidyl peptidase-4 inhibitor to oral semaglutide in Japanese patients with type 2 diabetes mellitus.","authors":"Chihiro Yoneda, Junji Kobayashi, Nobuichi Kuribayashi","doi":"10.1007/s13340-024-00734-5","DOIUrl":"10.1007/s13340-024-00734-5","url":null,"abstract":"<p><strong>Background: </strong>Dipeptidyl peptidase-4 inhibitors (DPP-4is) are the most widely used oral hypoglycemic drugs in Japan. However, once-daily oral semaglutide has been reported to reduce glycated hemoglobin (HbA1c) and body weight (BW) without causing significant hypoglycemia. Here, we aimed to evaluate the efficacy and safety of switching from a DPP-4i to oral semaglutide in Japanese patients with type 2 diabetes (T2D).</p><p><strong>Methods: </strong>We performed a single-center retrospective study of the changes in HbA1c and BW in 68 patients with T2D who were switched from a DPP-4i and took oral semaglutide for  ≥ 6 months, without changes in any other oral hypoglycemic agent.</p><p><strong>Results: </strong>Mean HbA1c decreased from 7.8 to 7.0% (<i>p</i> < 0.001) and BW decreased from 74.2 to 71.2 kg (<i>p</i> < 0.001) over 6 months. The decrease in HbA1c was more pronounced in participants with high baseline HbA1c (<i>r</i> =  - 0.542, <i>p</i> < 0.001). There was also a trend (<i>r</i> = 0.236, <i>p</i> = 0.052) toward a decrease in BW in individuals with shorter disease duration. There were reductions in either HbA1c or BW in 65 participants (95.6%). In addition, the larger the decrease in HbA1c was, the greater was the decrease in BW (<i>r</i> = 0.480, <i>p</i> < 0.001). Eighteen participants (20.1%) discontinued the drug within 6 months, of whom 10 (11.6% of the total) did so because of suspected adverse effects and the discontinuation rate was the highest in older, non-obese patients.</p><p><strong>Conclusions: </strong>Switching from a DPP-4i to oral semaglutide may be useful for Japanese patients with T2D who have inadequate glycemic or BW control. However, its utility may be limited by gastrointestinal adverse effects in certain patients.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"15 3","pages":"569-576"},"PeriodicalIF":1.3,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11291808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Diabetology International
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