首页 > 最新文献

TouchREVIEWS in endocrinology最新文献

英文 中文
Tirzepatide: A Novel, Once-weekly Dual GIP and GLP-1 Receptor Agonist for the Treatment of Type 2 Diabetes. 替西肽:一种治疗2型糖尿病的新型、每周一次的双GIP和GLP-1受体激动剂。
Pub Date : 2022-06-01 Epub Date: 2022-06-16 DOI: 10.17925/EE.2022.18.1.10
Shizuka Kaneko

Gastrointestinal hormones are currently used to treat type 2 diabetes mellitus (T2D). Incretin preparations with gastric inhibitory polypeptide (GIP) activity or glucagon-like peptide-1 (GLP-1) provide new means for controlling blood glucose levels, body weight, and lipid metabolism. GIP, an incretin, has not been used due to lack of promising action against diabetes. However, recent studies have shown that GIP has an important effect on glucagon and insulin secretion under normoglycaemic conditions. Co-existence of GIP with GLP-1 and glucagon signalling leads to a stronger effect than that of GLP-1 stimulation alone. The development of a GIP/GLP-1R unimolecular dual agonist with affinity for both GIP and GLP-1 receptors is under investigation, and the drug is expected to be clinically available in the near future. Tirzepatide, a GIP/GLP-1R unimolecular dual agonist, regulates metabolism via both peripheral organs and the central nervous system. The SURPASS phase III clinical trials conducted for tirzepatide comprise 10 clinical trials, including five global trials and the global SURPASS-CVOT trial, with >13,000 patients with T2D (ClinicalTrials.gov Identifier: NCT04255433). The clinical application of tirzepatide as a therapy for T2D may provide new insights into diabetic conditions and help clarify the role of GIP in its pathogenesis.

胃肠激素目前用于治疗2型糖尿病(T2D)。具有胃抑制多肽(GIP)活性或胰高血糖素样肽-1 (GLP-1)活性的肠促胰岛素制剂为控制血糖水平、体重和脂质代谢提供了新的手段。GIP是一种肠促胰岛素,由于缺乏对糖尿病有希望的作用而没有使用。然而,最近的研究表明,在正常血糖条件下,GIP对胰高血糖素和胰岛素的分泌有重要影响。GIP与GLP-1和胰高血糖素信号同时存在,比单独刺激GLP-1的作用更强。目前正在研究一种对GIP和GLP-1受体都具有亲和力的GIP/GLP-1R单分子双激动剂,该药物有望在不久的将来投入临床使用。tizepatide是一种GIP/GLP-1R单分子双激动剂,通过外周器官和中枢神经系统调节代谢。替西帕肽的transcend III期临床试验包括10项临床试验,包括5项全球试验和全球SURPASS- cvot试验,共有超过13,000名T2D患者(ClinicalTrials.gov Identifier: NCT04255433)。替西帕肽治疗T2D的临床应用可能为糖尿病提供新的认识,并有助于阐明GIP在其发病机制中的作用。
{"title":"Tirzepatide: A Novel, Once-weekly Dual GIP and GLP-1 Receptor Agonist for the Treatment of Type 2 Diabetes.","authors":"Shizuka Kaneko","doi":"10.17925/EE.2022.18.1.10","DOIUrl":"https://doi.org/10.17925/EE.2022.18.1.10","url":null,"abstract":"<p><p>Gastrointestinal hormones are currently used to treat type 2 diabetes mellitus (T2D). Incretin preparations with gastric inhibitory polypeptide (GIP) activity or glucagon-like peptide-1 (GLP-1) provide new means for controlling blood glucose levels, body weight, and lipid metabolism. GIP, an incretin, has not been used due to lack of promising action against diabetes. However, recent studies have shown that GIP has an important effect on glucagon and insulin secretion under normoglycaemic conditions. Co-existence of GIP with GLP-1 and glucagon signalling leads to a stronger effect than that of GLP-1 stimulation alone. The development of a GIP/GLP-1R unimolecular dual agonist with affinity for both GIP and GLP-1 receptors is under investigation, and the drug is expected to be clinically available in the near future. Tirzepatide, a GIP/GLP-1R unimolecular dual agonist, regulates metabolism via both peripheral organs and the central nervous system. The SURPASS phase III clinical trials conducted for tirzepatide comprise 10 clinical trials, including five global trials and the global SURPASS-CVOT trial, with >13,000 patients with T2D (ClinicalTrials.gov Identifier: NCT04255433). The clinical application of tirzepatide as a therapy for T2D may provide new insights into diabetic conditions and help clarify the role of GIP in its pathogenesis.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"18 1","pages":"10-19"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9354517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40616551","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: 10
Anterior Pituitary Hormones in Blood and Cerebrospinal Fluid of Patients in Neurocritical Care. 神经危重症患者血、脑脊液中垂体前叶激素的变化。
Pub Date : 2022-06-01 Epub Date: 2022-06-13 DOI: 10.17925/EE.2022.18.1.71
Henriette Beyer, Nicole Lange, Armin H Podtschaske, Jan Martin, Lucia Albers, Alexander von Werder, Jürgen Ruland, Gerhard Schneider, Bernhard Meyer, Simone M Kagerbauer, Jens Gempt

Background: Anterior pituitary hormones in blood follow a circadian rhythm, which may be influenced by various factors such as intracranial pathologies. In cerebrospinal fluid (CSF), pituitary hormones have been collected only selectively and circadian rhythm has not yet been investigated. This pilot study analysed diurnal variations of anterior pituitary hormones in patients in neurocritical care to determine whether circadian rhythmicity exists in these patients. Possible influences of intracranial pathologies were also investigated. Blood and CSF concentrations were assessed simultaneously to explore the value of blood concentrations as a surrogate parameter for CSF levels.

Methods: Blood and CSF samples of 20 non-sedated patients were collected at 06:00, noon, 18:00 and midnight, and analysed for adrenocorticotropic hormone (ACTH), cortisol, thyroid-stimulating hormone (TSH) and insulin-like growth factor-1 (IGF-1) concentrations at each of the four time points. ACTH and IGF-1 were measured by sandwich chemiluminescence immunoassay. Cortisol and TSH were measured by electrochemiluminescence immunoassay.

Results: Results showed inconsistent circadian rhythms. Less than 50% of the patients showed a circadian rhythmicity of ACTH, cortisol, TSH or IGF-1. Significance of diurnal variations was only present for blood concentrations of TSH. Correlations between blood and CSF concentrations were strong for cortisol and TSH.

Conclusions: CSF concentrations were only in the measurable range in some of the patients. No clear circadian rhythmicity could be identified, except for TSH in blood. Absence of significant diurnal variations could be explained by the underlying pathologies or disturbing influences of the intensive care unit. Blood concentrations of cortisol and TSH may be suitable surrogate parameters for CSF.

背景:血液中垂体前叶激素遵循昼夜节律,可能受到颅内病理等多种因素的影响。在脑脊液(CSF)中,垂体激素仅被选择性地收集,昼夜节律尚未被调查。本初步研究分析了神经危重症患者垂体前叶激素的日变化,以确定这些患者是否存在昼夜节律性。颅内病变可能的影响也进行了探讨。同时评估血液和脑脊液浓度,以探讨血液浓度作为脑脊液水平的替代参数的价值。方法:20例非镇静患者于06:00、中午、18:00和午夜采集血液和脑脊液,分析促肾上腺皮质激素(ACTH)、皮质醇、促甲状腺激素(TSH)和胰岛素样生长因子-1 (IGF-1)浓度。采用夹心化学发光免疫法检测ACTH和IGF-1。电化学发光免疫法测定皮质醇和TSH。结果:结果显示昼夜节律不一致。不到50%的患者表现出ACTH、皮质醇、TSH或IGF-1的昼夜节律性。日变化的意义只存在于血液中TSH浓度。皮质醇和TSH在血液和脑脊液浓度之间的相关性很强。结论:部分患者脑脊液浓度仅在可测范围内。除了血液中的TSH外,没有明确的昼夜节律性。没有明显的日变化可以解释为潜在的病理或重症监护病房的干扰影响。血中皮质醇和TSH浓度可能是CSF的合适替代参数。
{"title":"Anterior Pituitary Hormones in Blood and Cerebrospinal Fluid of Patients in Neurocritical Care.","authors":"Henriette Beyer,&nbsp;Nicole Lange,&nbsp;Armin H Podtschaske,&nbsp;Jan Martin,&nbsp;Lucia Albers,&nbsp;Alexander von Werder,&nbsp;Jürgen Ruland,&nbsp;Gerhard Schneider,&nbsp;Bernhard Meyer,&nbsp;Simone M Kagerbauer,&nbsp;Jens Gempt","doi":"10.17925/EE.2022.18.1.71","DOIUrl":"https://doi.org/10.17925/EE.2022.18.1.71","url":null,"abstract":"<p><strong>Background: </strong>Anterior pituitary hormones in blood follow a circadian rhythm, which may be influenced by various factors such as intracranial pathologies. In cerebrospinal fluid (CSF), pituitary hormones have been collected only selectively and circadian rhythm has not yet been investigated. This pilot study analysed diurnal variations of anterior pituitary hormones in patients in neurocritical care to determine whether circadian rhythmicity exists in these patients. Possible influences of intracranial pathologies were also investigated. Blood and CSF concentrations were assessed simultaneously to explore the value of blood concentrations as a surrogate parameter for CSF levels.</p><p><strong>Methods: </strong>Blood and CSF samples of 20 non-sedated patients were collected at 06:00, noon, 18:00 and midnight, and analysed for adrenocorticotropic hormone (ACTH), cortisol, thyroid-stimulating hormone (TSH) and insulin-like growth factor-1 (IGF-1) concentrations at each of the four time points. ACTH and IGF-1 were measured by sandwich chemiluminescence immunoassay. Cortisol and TSH were measured by electrochemiluminescence immunoassay.</p><p><strong>Results: </strong>Results showed inconsistent circadian rhythms. Less than 50% of the patients showed a circadian rhythmicity of ACTH, cortisol, TSH or IGF-1. Significance of diurnal variations was only present for blood concentrations of TSH. Correlations between blood and CSF concentrations were strong for cortisol and TSH.</p><p><strong>Conclusions: </strong>CSF concentrations were only in the measurable range in some of the patients. No clear circadian rhythmicity could be identified, except for TSH in blood. Absence of significant diurnal variations could be explained by the underlying pathologies or disturbing influences of the intensive care unit. Blood concentrations of cortisol and TSH may be suitable surrogate parameters for CSF.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"18 1","pages":"71-79"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9354947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40616555","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
Utilizing the New Glucometrics: A Practical Guide to Ambulatory Glucose Profile Interpretation. 利用新的葡萄糖测量:一个实用的指南,动态葡萄糖剖面解释。
Pub Date : 2022-06-01 Epub Date: 2022-06-13 DOI: 10.17925/EE.2022.18.1.20
John Doupis, Edward S Horton

Traditional continuous glucose monitoring and flash glucose monitoring systems are proven to lower glycated haemoglobin levels, decrease the time and impact of hypoglycaemia or hyperglycaemia and, consequently, improve the quality of life for children and adults with type 1 diabetes mellitus (T1DM) and adults with type 2 diabetes mellitus (T2DM). These glucose-sensing devices can generate large amounts of glucose data that can be used to define a detailed glycaemic profile for each user, which can be compared with targets for glucose control set by an International Consensus Panel of diabetes experts. Targets have been agreed upon for adults, children and adolescents with T1DM and adults with T2DM; separate targets have been agreed upon for older adults with diabetes, who are at higher risk of hypoglycaemia, and women with pregestational T1DM during pregnancy. Along with the objective measures and targets identified by the International Consensus Panel, the dense glucose data delivered by traditional continuous glucose monitoring and flash glucose monitoring systems is used to generate an ambulatory glucose profile, which summarizes the data in a visually impactful format that can be used to identify patterns and trends in daily glucose control, including those that raise clinical concerns. In this article, we provide a practical guide on how to interpret these new glucometrics using a straightforward algorithm, and clear visual examples that demystify the process of reviewing the glycaemic health of people with T1DM or T2DM such that forward-looking goals for diabetes management can be agreed.

传统的连续血糖监测和瞬时血糖监测系统被证明可以降低糖化血红蛋白水平,减少低血糖或高血糖的时间和影响,从而改善儿童和成人1型糖尿病(T1DM)和成人2型糖尿病(T2DM)的生活质量。这些血糖传感设备可以产生大量的葡萄糖数据,这些数据可以用来为每个用户定义详细的血糖概况,这些数据可以与国际糖尿病专家共识小组设定的血糖控制目标进行比较。已就成人、儿童和青少年T1DM和成人T2DM的目标达成一致;对于低血糖风险较高的老年糖尿病患者和妊娠期患有T1DM的妇女,已经达成了单独的目标。与国际共识小组确定的客观测量和目标一起,传统连续血糖监测和快速血糖监测系统提供的密集血糖数据被用于生成动态血糖概况,该数据以视觉上有影响力的格式总结,可用于识别日常血糖控制的模式和趋势,包括那些引起临床关注的模式和趋势。在这篇文章中,我们提供了一个实用的指南,说明如何使用一个简单的算法来解释这些新的血糖测量,并提供了清晰的视觉示例,揭示了审查1型糖尿病或2型糖尿病患者血糖健康的过程,从而可以就糖尿病管理的前瞻性目标达成一致。
{"title":"Utilizing the New Glucometrics: A Practical Guide to Ambulatory Glucose Profile Interpretation.","authors":"John Doupis,&nbsp;Edward S Horton","doi":"10.17925/EE.2022.18.1.20","DOIUrl":"https://doi.org/10.17925/EE.2022.18.1.20","url":null,"abstract":"<p><p>Traditional continuous glucose monitoring and flash glucose monitoring systems are proven to lower glycated haemoglobin levels, decrease the time and impact of hypoglycaemia or hyperglycaemia and, consequently, improve the quality of life for children and adults with type 1 diabetes mellitus (T1DM) and adults with type 2 diabetes mellitus (T2DM). These glucose-sensing devices can generate large amounts of glucose data that can be used to define a detailed glycaemic profile for each user, which can be compared with targets for glucose control set by an International Consensus Panel of diabetes experts. Targets have been agreed upon for adults, children and adolescents with T1DM and adults with T2DM; separate targets have been agreed upon for older adults with diabetes, who are at higher risk of hypoglycaemia, and women with pregestational T1DM during pregnancy. Along with the objective measures and targets identified by the International Consensus Panel, the dense glucose data delivered by traditional continuous glucose monitoring and flash glucose monitoring systems is used to generate an ambulatory glucose profile, which summarizes the data in a visually impactful format that can be used to identify patterns and trends in daily glucose control, including those that raise clinical concerns. In this article, we provide a practical guide on how to interpret these new glucometrics using a straightforward algorithm, and clear visual examples that demystify the process of reviewing the glycaemic health of people with T1DM or T2DM such that forward-looking goals for diabetes management can be agreed.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"18 1","pages":"20-26"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9354515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40696982","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
Diagnostic Test Accuracy of Urine C-peptide Creatinine Ratio for the Correct Identification of the Type of Diabetes: A Systematic Review. 尿c肽肌酐比值对正确识别糖尿病类型的诊断试验准确性:一项系统评价。
Pub Date : 2022-06-01 Epub Date: 2022-05-23 DOI: 10.17925/EE.2022.18.1.2
Joseph M Pappachan, Bhuvana Sunil, Cornelius J Fernandez, Ian M Lahart, Ambika P Ashraf

Objective: To examine the accuracy of urine c-peptide creatinine ratio (UCPCR) for identifying the type of diabetes in appropriate clinical settings. Design: Systematic review of test accuracy studies on patients with different forms of diabetes. Data sources: Medline, Embase and Cochrane library databases from 1 January 2000 to 15 November 2020. Eligibility criteria: Studies reporting the use of UCPCR for diagnosing patients with type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM) and monogenic forms of diabetes (categorized as maturity-onset diabetes of the young [MODY]). Study selection and data synthesis: Two reviewers independently assessed articles for inclusion and assessed the methodological quality of the studies using the Quality Assessment of Diagnostic Accuracy Studies-2 tool, with input from a third reviewer to reach consensus when there was a dispute. Meta-analysis was performed with the studies reporting complete data to derive the pooled sensitivity, specificity and diagnostic odds ratio (DOR), and narrative synthesis only for those with incomplete data. Results: Nine studies with 4,488 patients were included in the qualitative synthesis, while only four of these (915 patients) had complete data and were included in the quantitative synthesis. All the studies had moderate risk of bias and applicability concerns. Meta-analysis of three studies (n=130) revealed sensitivity, specificity and DOR of 84.4% (95% confidence interval [CI] 68.1-93.2%), 91.6% (82.8-96.1%) and 59.9 (32.8-106.0), respectively, for diagnosing T1DM using a UCPCR cut-off of <0.2 nmol/mmol. For participants with T2DM (three studies; n=739), UCPCR >0.2 nmol/mmol was associated with sensitivity, specificity and DOR of 92.8% (84.2-96.9%), 81.6% (61.3-92.5%) and 56.9 (31.3-103.5), respectively. For patients with MODY in the appropriate clinical setting, a UCPCR cut-off of >0.2 nmol/mmol showed sensitivity, specificity and DOR of 85.2% (73.1-92.4%), 98.0% (92.4-99.5%) and 281.8 (57.5-1,379.7), respectively. Conclusions: Based on studies with moderate risk of bias and applicability concerns, UCPCR confers moderate to high sensitivity, specificity, and DOR for correctly identifying T1DM, T2DM and monogenic diabetes in appropriate clinical settings. Large multinational studies with multi-ethnic participation among different age groups are necessary before this test can be routinely used in clinical practice. Study registration: Protocol was registered as PROSPERO CRD42017060633.

目的:探讨尿c肽肌酐比值(UCPCR)在临床诊断糖尿病时的准确性。设计:对不同类型糖尿病患者的检测准确性研究进行系统回顾。数据来源:Medline, Embase和Cochrane图书馆数据库,2000年1月1日至2020年11月15日。入选标准:研究报告使用UCPCR诊断1型糖尿病(T1DM)、2型糖尿病(T2DM)和单基因型糖尿病(归类为年轻人的成熟型糖尿病[MODY])。研究选择和数据综合:两位审稿人使用诊断准确性研究质量评估-2工具独立评估文章的纳入和评估研究的方法学质量,当有争议时,第三位审稿人会提供意见以达成共识。对报告完整数据的研究进行荟萃分析,得出汇总敏感性、特异性和诊断优势比(DOR),并仅对数据不完整的研究进行叙事综合。结果:9项研究共4488例患者被纳入定性综合,其中只有4项研究(915例)数据完整,被纳入定量综合。所有研究均存在中等偏倚风险和适用性问题。3项研究(n=130)的荟萃分析显示,使用0.2 nmol/mmol的UCPCR截止值诊断T1DM的敏感性、特异性和DOR分别为84.4%(95%可信区间[CI] 68.1-93.2%)、91.6%(82.8-96.1%)和59.9(32.8-106.0),敏感性、特异性和DOR分别为92.8%(84.2-96.9%)、81.6%(61.3-92.5%)和56.9(31.3-103.5)。对于MODY患者,在合适的临床环境下,UCPCR截止值>0.2 nmol/mmol的敏感性、特异性和DOR分别为85.2%(73.1-92.4%)、98.0%(92.4-99.5%)和281.8(57.5- 1379.7)。结论:基于具有中等偏倚风险和适用性问题的研究,在适当的临床环境中,UCPCR在正确识别T1DM、T2DM和单基因糖尿病方面具有中等至高的敏感性、特异性和DOR。在该测试常规应用于临床实践之前,需要在不同年龄组中进行多民族参与的大型多国研究。研究注册:协议注册号为PROSPERO CRD42017060633。
{"title":"Diagnostic Test Accuracy of Urine C-peptide Creatinine Ratio for the Correct Identification of the Type of Diabetes: A Systematic Review.","authors":"Joseph M Pappachan,&nbsp;Bhuvana Sunil,&nbsp;Cornelius J Fernandez,&nbsp;Ian M Lahart,&nbsp;Ambika P Ashraf","doi":"10.17925/EE.2022.18.1.2","DOIUrl":"https://doi.org/10.17925/EE.2022.18.1.2","url":null,"abstract":"<p><p><b>Objective</b>: To examine the accuracy of urine c-peptide creatinine ratio (UCPCR) for identifying the type of diabetes in appropriate clinical settings. <b>Design</b>: Systematic review of test accuracy studies on patients with different forms of diabetes. <b>Data sources</b>: Medline, Embase and Cochrane library databases from 1 January 2000 to 15 November 2020. <b>Eligibility criteria</b>: Studies reporting the use of UCPCR for diagnosing patients with type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM) and monogenic forms of diabetes (categorized as maturity-onset diabetes of the young [MODY]). <b>Study selection and data synthesis</b>: Two reviewers independently assessed articles for inclusion and assessed the methodological quality of the studies using the Quality Assessment of Diagnostic Accuracy Studies-2 tool, with input from a third reviewer to reach consensus when there was a dispute. Meta-analysis was performed with the studies reporting complete data to derive the pooled sensitivity, specificity and diagnostic odds ratio (DOR), and narrative synthesis only for those with incomplete data. <b>Results</b>: Nine studies with 4,488 patients were included in the qualitative synthesis, while only four of these (915 patients) had complete data and were included in the quantitative synthesis. All the studies had moderate risk of bias and applicability concerns. Meta-analysis of three studies (n=130) revealed sensitivity, specificity and DOR of 84.4% (95% confidence interval [CI] 68.1-93.2%), 91.6% (82.8-96.1%) and 59.9 (32.8-106.0), respectively, for diagnosing T1DM using a UCPCR cut-off of <0.2 nmol/mmol. For participants with T2DM (three studies; n=739), UCPCR >0.2 nmol/mmol was associated with sensitivity, specificity and DOR of 92.8% (84.2-96.9%), 81.6% (61.3-92.5%) and 56.9 (31.3-103.5), respectively. For patients with MODY in the appropriate clinical setting, a UCPCR cut-off of >0.2 nmol/mmol showed sensitivity, specificity and DOR of 85.2% (73.1-92.4%), 98.0% (92.4-99.5%) and 281.8 (57.5-1,379.7), respectively. <b>Conclusions</b>: Based on studies with moderate risk of bias and applicability concerns, UCPCR confers moderate to high sensitivity, specificity, and DOR for correctly identifying T1DM, T2DM and monogenic diabetes in appropriate clinical settings. Large multinational studies with multi-ethnic participation among different age groups are necessary before this test can be routinely used in clinical practice. <b>Study registration</b>: Protocol was registered as PROSPERO CRD42017060633.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"18 1","pages":"2-9"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9354948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40696984","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: 1
Indian Phenotype Characteristics Among Patients with Type 2 Diabetes Mellitus: Insights from a Non-interventional Nationwide Registry in India. 2型糖尿病患者的印度表型特征:来自印度非干预性全国登记的见解
Pub Date : 2022-06-01 Epub Date: 2022-05-30 DOI: 10.17925/EE.2022.18.1.63
Sanjay Kalra, Ambrish Mithal, Abdul Hamid Zargar, Bipin Sethi, Mala Dharmalingam, Sujoy Ghosh, Ranjini Sen

Background: Indian patients with type 2 diabetes mellitus (T2D) constitute one-sixth of affected adults globally. Here, we evaluate the association of body mass index (BMI) with body fat percentage (BF%) and glycated haemoglobin (HbA1c) levels among patients with T2D in India. Method: This was a cross-sectional Indian registry study across 845 geographically diverse zones between December 2017 and August 2019. Results: Of 37,927 patients, 55.6% were men, with a mean ± standard deviation age of 54.2 ± 11.5 years and HbA1c of 8.3 ± 1.71%. Mean ± standard deviation BMI and BF% were 27.0 ± 4.6 kg/m2 and 32.0 ± 8.0%, respectively. Overall, 15.4% of patients were overweight, and 25.0% were obese. Despite fewer males (20.7%) having BMI-based obesity than females (31.2%), around three-quarters of both sexes had BF%-defined obesity (males 77.2%; females 71.2%). One-third of males (34.6%) and 41.9% of females had BF%-defined obesity despite normal BMI. The association was substantiated by a moderately significant correlation (r=0.51) between BMI and BF% in the overall population (p<0.0001). Conclusion: This pan-India registry presents a real-world reflection of the Asian Indian phenotype: high BF% despite lower BMI in people with T2D. This highlights the importance of primordial and primary prevention, and may guide decisions on the choice of agents for glycaemic control, with a preference for drugs that promote weight loss or are weight neutral.

背景:印度2型糖尿病(T2D)患者占全球受影响成人的六分之一。在这里,我们评估了印度t2dm患者的身体质量指数(BMI)与体脂率(BF%)和糖化血红蛋白(HbA1c)水平的关系。方法:这是一项横断面印度登记研究,涵盖2017年12月至2019年8月期间845个地理上不同的地区。结果:37927例患者中,男性占55.6%,平均±标准差年龄为54.2±11.5岁,HbA1c为8.3±1.71%。BMI和BF%的均值±标准差分别为27.0±4.6 kg/m2和32.0±8.0%。总体而言,15.4%的患者超重,25.0%的患者肥胖。尽管男性(20.7%)比女性(31.2%)更少患有基于bmi的肥胖,但男女中约有四分之三的人患有BF%定义的肥胖(男性77.2%;女性71.2%)。三分之一的男性(34.6%)和41.9%的女性患有BF%定义的肥胖,尽管BMI正常。在总体人群中,BMI和BF%之间存在中等显著相关性(r=0.51),证实了这种关联。结论:这个泛印度注册表反映了亚洲印度人的真实表型:T2D患者的BF%高,BMI低。这突出了原始预防和初级预防的重要性,并可能指导血糖控制药物的选择,优先选择促进体重减轻或体重中性的药物。
{"title":"Indian Phenotype Characteristics Among Patients with Type 2 Diabetes Mellitus: Insights from a Non-interventional Nationwide Registry in India.","authors":"Sanjay Kalra,&nbsp;Ambrish Mithal,&nbsp;Abdul Hamid Zargar,&nbsp;Bipin Sethi,&nbsp;Mala Dharmalingam,&nbsp;Sujoy Ghosh,&nbsp;Ranjini Sen","doi":"10.17925/EE.2022.18.1.63","DOIUrl":"https://doi.org/10.17925/EE.2022.18.1.63","url":null,"abstract":"<p><p><b>Background</b>: Indian patients with type 2 diabetes mellitus (T2D) constitute one-sixth of affected adults globally. Here, we evaluate the association of body mass index (BMI) with body fat percentage (BF%) and glycated haemoglobin (HbA1c) levels among patients with T2D in India. <b>Method</b>: This was a cross-sectional Indian registry study across 845 geographically diverse zones between December 2017 and August 2019. <b>Results</b>: Of 37,927 patients, 55.6% were men, with a mean ± standard deviation age of 54.2 ± 11.5 years and HbA1c of 8.3 ± 1.71%. Mean ± standard deviation BMI and BF% were 27.0 ± 4.6 kg/m2 and 32.0 ± 8.0%, respectively. Overall, 15.4% of patients were overweight, and 25.0% were obese. Despite fewer males (20.7%) having BMI-based obesity than females (31.2%), around three-quarters of both sexes had BF%-defined obesity (males 77.2%; females 71.2%). One-third of males (34.6%) and 41.9% of females had BF%-defined obesity despite normal BMI. The association was substantiated by a moderately significant correlation (r=0.51) between BMI and BF% in the overall population (p<0.0001). <b>Conclusion</b>: This pan-India registry presents a real-world reflection of the Asian Indian phenotype: high BF% despite lower BMI in people with T2D. This highlights the importance of primordial and primary prevention, and may guide decisions on the choice of agents for glycaemic control, with a preference for drugs that promote weight loss or are weight neutral.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"18 1","pages":"63-70"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9354966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40696983","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
Review of Automated Insulin Delivery Systems for Type 1 Diabetes and Associated Time in Range Outcomes. 1 型糖尿病自动胰岛素输送系统及相关时间范围结果回顾。
Pub Date : 2022-06-01 Epub Date: 2022-05-20 DOI: 10.17925/EE.2022.18.1.27
Armaan Nallicheri, Katherine M Mahoney, Hanna A Gutow, Natalie Bellini, Diana Isaacs

Automated insulin delivery (AID) systems play an important role in the management of type 1 diabetes mellitus (T1DM). These systems include three components: a continuous glucose monitor (CGM), an insulin pump and an algorithm that adjusts the pump based on the CGM sensor glucose readings. They are not fully automated and still require the user to administer bolus insulin doses for food. Some AID systems have automatic correction boluses, while others only have automatic basal or background insulin adjustments. As CGM has become more accurate and the technology has evolved, AID systems have demonstrated improved glycaemic outcomes. The clinical evaluation of AID systems in randomized controlled trials and real-world studies have shown their utility in helping glycaemic management. In this review, we compare AID systems that are commercially available in the US and summarize the literature, with a special focus on time in range in T1DM. The review also discusses new AID systems on the horizon and explores considerations for personalized care.

胰岛素自动给药系统(AID)在 1 型糖尿病(T1DM)的治疗中发挥着重要作用。这些系统包括三个组成部分:连续血糖监测仪(CGM)、胰岛素泵和根据 CGM 传感器血糖读数调整泵的算法。这些系统并非完全自动化,仍需要用户为食物注射胰岛素。有些 AID 系统具有自动校正胰岛素剂量的功能,而有些则只有自动调整基础或背景胰岛素的功能。随着 CGM 的精确度提高和技术的发展,AID 系统的血糖治疗效果也得到了改善。在随机对照试验和实际研究中对 AID 系统进行的临床评估表明,它们在帮助进行血糖管理方面非常有用。在这篇综述中,我们比较了美国市售的 AID 系统,并总结了相关文献,特别关注了 T1DM 患者的血糖控制时间。综述还讨论了即将推出的新型 AID 系统,并探讨了个性化护理的注意事项。
{"title":"Review of Automated Insulin Delivery Systems for Type 1 Diabetes and Associated Time in Range Outcomes.","authors":"Armaan Nallicheri, Katherine M Mahoney, Hanna A Gutow, Natalie Bellini, Diana Isaacs","doi":"10.17925/EE.2022.18.1.27","DOIUrl":"10.17925/EE.2022.18.1.27","url":null,"abstract":"<p><p>Automated insulin delivery (AID) systems play an important role in the management of type 1 diabetes mellitus (T1DM). These systems include three components: a continuous glucose monitor (CGM), an insulin pump and an algorithm that adjusts the pump based on the CGM sensor glucose readings. They are not fully automated and still require the user to administer bolus insulin doses for food. Some AID systems have automatic correction boluses, while others only have automatic basal or background insulin adjustments. As CGM has become more accurate and the technology has evolved, AID systems have demonstrated improved glycaemic outcomes. The clinical evaluation of AID systems in randomized controlled trials and real-world studies have shown their utility in helping glycaemic management. In this review, we compare AID systems that are commercially available in the US and summarize the literature, with a special focus on time in range in T1DM. The review also discusses new AID systems on the horizon and explores considerations for personalized care.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"18 1","pages":"27-34"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9354504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40616552","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
Novel Insights Into the Genetic Causes of Short Stature in Children. 对儿童身材矮小的遗传原因的新见解。
Pub Date : 2022-06-01 Epub Date: 2022-05-25 DOI: 10.17925/EE.2022.18.1.49
Concetta Mastromauro, Francesco Chiarelli

Short stature is a common reason for consulting a growth specialist during childhood. Normal height is a polygenic trait involving a complex interaction between hormonal, nutritional and psychosocial components. Genetic factors are becoming very important in the understanding of short stature. After exclusion of the most frequent causes of growth failure, clinicians need to evaluate whether a genetic cause might be taken into consideration. In fact, genetic causes of short stature are probably misdiagnosed during clinical practice and the underlying cause of short stature frequently remains unknown, thus classifying children as having idiopathic short stature (ISS). However, over the past decade, novel genetic techniques have led to the discovery of novel genes associated with linear growth and thus to the ability to define new possible aetiologies of short stature. In fact, thanks to the newer genetic advances, it is possible to properly re-classify about 25-40% of children previously diagnosed with ISS. The purpose of this article is to describe the main monogenic causes of short stature, which, thanks to advances in molecular genetics, are assuming an increasingly important role in the clinical approach to short children.

身材矮小是儿童时期咨询生长专家的常见原因。正常身高是一种多基因性状,涉及荷尔蒙、营养和社会心理因素之间复杂的相互作用。遗传因素在理解身材矮小方面变得非常重要。排除生长衰竭最常见的原因后,临床医生需要评估是否考虑遗传原因。事实上,在临床实践中,矮小的遗传原因很可能被误诊,矮小的根本原因经常是未知的,因此将儿童归类为特发性矮小(ISS)。然而,在过去的十年中,新的遗传技术已经导致与线性生长相关的新基因的发现,从而有能力定义新的可能的矮小病因。事实上,由于新的遗传学进展,有可能正确地重新分类大约25-40%以前被诊断为ISS的儿童。本文的目的是描述身材矮小的主要单基因原因,由于分子遗传学的进步,这些原因在矮小儿童的临床治疗中扮演着越来越重要的角色。
{"title":"Novel Insights Into the Genetic Causes of Short Stature in Children.","authors":"Concetta Mastromauro,&nbsp;Francesco Chiarelli","doi":"10.17925/EE.2022.18.1.49","DOIUrl":"https://doi.org/10.17925/EE.2022.18.1.49","url":null,"abstract":"<p><p>Short stature is a common reason for consulting a growth specialist during childhood. Normal height is a polygenic trait involving a complex interaction between hormonal, nutritional and psychosocial components. Genetic factors are becoming very important in the understanding of short stature. After exclusion of the most frequent causes of growth failure, clinicians need to evaluate whether a genetic cause might be taken into consideration. In fact, genetic causes of short stature are probably misdiagnosed during clinical practice and the underlying cause of short stature frequently remains unknown, thus classifying children as having idiopathic short stature (ISS). However, over the past decade, novel genetic techniques have led to the discovery of novel genes associated with linear growth and thus to the ability to define new possible aetiologies of short stature. In fact, thanks to the newer genetic advances, it is possible to properly re-classify about 25-40% of children previously diagnosed with ISS. The purpose of this article is to describe the main monogenic causes of short stature, which, thanks to advances in molecular genetics, are assuming an increasingly important role in the clinical approach to short children.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"18 1","pages":"49-57"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9354945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40696986","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: 1
Once-weekly 2.4 mg Semaglutide for Weight Management in Obesity: A Game Changer? 每周一次2.4毫克西马鲁肽用于肥胖患者的体重管理:改变游戏规则?
Pub Date : 2022-06-01 Epub Date: 2022-06-15 DOI: 10.17925/EE.2022.18.1.35
Ides M Colin, Katherine M Gérard

The treatment of obesity can no longer be reduced to a simplistic view of weight loss. Metabolic adaptation leads to systematic weight regain following weight-loss efforts, and new obesity treatments should therefore aim to induce long-standing double-digit weight loss, and thus improve and even reverse obesity-associated comorbidities such as type 2 diabetes. Until now, only metabolic surgery has been able to achieve such a goal, but this invasive procedure cannot be offered on a large scale. Among the alternatives, lifestyle interventions and drug therapies have often been disappointing. The recent availability of once-weekly subcutaneous 2.4 mg semaglutide (a glucagon-like peptide-1 receptor agonist; Wegovy™ Novo Nordisk A/S, Bagsværd, Denmark) has changed the scene, and semaglutide is considered a 'game changer' in the treatment of obesity. The results from the phase III STEP (Semaglutide treatment effect in people with obesity) clinical programme have shown that semaglutide provides clinically meaningful and sustained weight loss in ranges much higher than those achieved with previously available pharmacotherapies. These results led to the approval of semaglutide by regulatory authorities as an adjunct to a reduced-calorie diet and increased physical activity in people with obesity or overweight, with at least one weight-related comorbidity. With data from phase II and III clinical trials showing that newer drugs (i.e. the glucagon-like peptide-1 and gastric inhibitory polypeptide dual receptor agonist tirzepatide and the amylin agonist cagrilintide, either alone or combined) produce a greater sustained weight loss than semaglutide, an upstream 'weight-centric' strategy has emerged as a new standard for the treatment of type 2 diabetes.

肥胖的治疗不能再被简化为减肥的简单观点。代谢适应导致减肥后的系统性体重恢复,因此新的肥胖治疗应该旨在诱导长期两位数的体重减轻,从而改善甚至逆转肥胖相关的合并症,如2型糖尿病。到目前为止,只有代谢手术能够实现这一目标,但这种侵入性手术无法大规模提供。在替代疗法中,生活方式干预和药物治疗往往令人失望。最近可获得每周一次皮下2.4 mg semaglutide(一种胰高血糖素样肽-1受体激动剂;Wegovy™Novo Nordisk A/S, Bagsværd,丹麦)已经改变了这一场景,semaglutide被认为是肥胖治疗的“游戏规则改变者”。来自III期STEP (Semaglutide治疗肥胖患者的效果)临床项目的结果表明,Semaglutide提供的临床意义和持续的体重减轻范围远远高于以前可用的药物治疗。这些结果导致监管机构批准西马鲁肽作为肥胖或超重人群减少卡路里饮食和增加体力活动的辅助药物,至少有一种与体重相关的合并症。II期和III期临床试验的数据显示,较新的药物(即胰高血糖素样肽-1和胃抑制多肽双受体激动剂tizepatide和amylin激动剂cagrilintide,单独或联合使用)比semaglutide产生更大的持续减肥效果,上游“以体重为中心”的策略已经成为治疗2型糖尿病的新标准。
{"title":"Once-weekly 2.4 mg Semaglutide for Weight Management in Obesity: A Game Changer?","authors":"Ides M Colin,&nbsp;Katherine M Gérard","doi":"10.17925/EE.2022.18.1.35","DOIUrl":"https://doi.org/10.17925/EE.2022.18.1.35","url":null,"abstract":"<p><p>The treatment of obesity can no longer be reduced to a simplistic view of weight loss. Metabolic adaptation leads to systematic weight regain following weight-loss efforts, and new obesity treatments should therefore aim to induce long-standing double-digit weight loss, and thus improve and even reverse obesity-associated comorbidities such as type 2 diabetes. Until now, only metabolic surgery has been able to achieve such a goal, but this invasive procedure cannot be offered on a large scale. Among the alternatives, lifestyle interventions and drug therapies have often been disappointing. The recent availability of once-weekly subcutaneous 2.4 mg semaglutide (a glucagon-like peptide-1 receptor agonist; Wegovy™ Novo Nordisk A/S, Bagsværd, Denmark) has changed the scene, and semaglutide is considered a 'game changer' in the treatment of obesity. The results from the phase III STEP (Semaglutide treatment effect in people with obesity) clinical programme have shown that semaglutide provides clinically meaningful and sustained weight loss in ranges much higher than those achieved with previously available pharmacotherapies. These results led to the approval of semaglutide by regulatory authorities as an adjunct to a reduced-calorie diet and increased physical activity in people with obesity or overweight, with at least one weight-related comorbidity. With data from phase II and III clinical trials showing that newer drugs (i.e. the glucagon-like peptide-1 and gastric inhibitory polypeptide dual receptor agonist tirzepatide and the amylin agonist cagrilintide, either alone or combined) produce a greater sustained weight loss than semaglutide, an upstream 'weight-centric' strategy has emerged as a new standard for the treatment of type 2 diabetes.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"18 1","pages":"35-42"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9354513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40616553","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: 1
Glucagon-like Peptide-1 Receptor Analogues for the Treatment of Obesity. 胰高血糖素样肽-1受体类似物治疗肥胖。
Pub Date : 2022-03-01 Epub Date: 2022-03-18 DOI: 10.17925/EE.2022.18.1.43
David M Williams, Matthew Staff, Stephen C Bain, Thinzar Min

There is an increasing prevalence of obesity worldwide, associated with significant morbidity and mortality, which frequently reduces quality of life and life expectancy. Consequently, there is a substantial and growing personal and economic burden necessitating the development of more effective therapies for obesity. Glucagon-like peptide-1 receptor analogues (GLP-1RAs) are licensed for the treatment of type 2 diabetes (T2D), and there is substantial evidence that these drugs not only improve cardiovascular outcomes but also promote weight loss. More recent evidence supports the use of the GLP-1RAs liraglutide and semaglutide in people with obesity without T2D. This article discusses the results of the major cardiovascular outcome trials for GLP-1RAs in people with T2D, the SCALE Obesity and Prediabetes study (Effect of liraglutide on body weight in non-diabetic obese subjects or overweight subjects with co-morbidities: SCALE™ - Obesity and Pre-diabetes; ClinicalTrials.gov identifier: NCT01272219; investigating liraglutide) and the STEP studies (Semaglutide treatment effect in people with obesity; assorted studies; investigating subcutaneous semaglutide). We also highlight the importance of a cost-effective approach to obesity pharmacotherapy. Clinicians should consider the use of GLP-1RAs in people with obesity, especially those with T2D or other obesity-related diseases, such as hypertension and dyslipidaemia. Ongoing trials, as well as clinical and cost-effectiveness appraisals, are anticipated over the next 12 months, and their findings may change the current landscape of obesity pharmacotherapy.

肥胖在世界范围内日益流行,与显著的发病率和死亡率相关,经常降低生活质量和预期寿命。因此,有一个巨大的和不断增长的个人和经济负担,需要发展更有效的治疗肥胖的方法。胰高血糖素样肽-1受体类似物(GLP-1RAs)被批准用于治疗2型糖尿病(T2D),有大量证据表明这些药物不仅可以改善心血管结局,还可以促进体重减轻。最近更多的证据支持GLP-1RAs利拉鲁肽和semaglutide用于无T2D的肥胖患者。本文讨论了GLP-1RAs在T2D患者中的主要心血管结局试验的结果,即SCALE肥胖和前驱糖尿病研究(利拉鲁肽对非糖尿病性肥胖受试者或伴有合并症的超重受试者体重的影响:SCALE™-肥胖和前驱糖尿病;ClinicalTrials.gov识别码:NCT01272219;调查利拉鲁肽)和STEP研究(西玛鲁肽治疗肥胖患者的效果;各种各样的研究;研究皮下semaglutide)。我们还强调了成本效益的方法对肥胖药物治疗的重要性。临床医生应考虑在肥胖患者中使用GLP-1RAs,特别是那些患有T2D或其他肥胖相关疾病的患者,如高血压和血脂异常。正在进行的试验以及临床和成本效益评估预计将在未来12个月内进行,他们的发现可能会改变目前肥胖药物治疗的现状。
{"title":"Glucagon-like Peptide-1 Receptor Analogues for the Treatment of Obesity.","authors":"David M Williams,&nbsp;Matthew Staff,&nbsp;Stephen C Bain,&nbsp;Thinzar Min","doi":"10.17925/EE.2022.18.1.43","DOIUrl":"https://doi.org/10.17925/EE.2022.18.1.43","url":null,"abstract":"<p><p>There is an increasing prevalence of obesity worldwide, associated with significant morbidity and mortality, which frequently reduces quality of life and life expectancy. Consequently, there is a substantial and growing personal and economic burden necessitating the development of more effective therapies for obesity. Glucagon-like peptide-1 receptor analogues (GLP-1RAs) are licensed for the treatment of type 2 diabetes (T2D), and there is substantial evidence that these drugs not only improve cardiovascular outcomes but also promote weight loss. More recent evidence supports the use of the GLP-1RAs liraglutide and semaglutide in people with obesity without T2D. This article discusses the results of the major cardiovascular outcome trials for GLP-1RAs in people with T2D, the SCALE Obesity and Prediabetes study (Effect of liraglutide on body weight in non-diabetic obese subjects or overweight subjects with co-morbidities: SCALE™ - Obesity and Pre-diabetes; ClinicalTrials.gov identifier: NCT01272219; investigating liraglutide) and the STEP studies (Semaglutide treatment effect in people with obesity; assorted studies; investigating subcutaneous semaglutide). We also highlight the importance of a cost-effective approach to obesity pharmacotherapy. Clinicians should consider the use of GLP-1RAs in people with obesity, especially those with T2D or other obesity-related diseases, such as hypertension and dyslipidaemia. Ongoing trials, as well as clinical and cost-effectiveness appraisals, are anticipated over the next 12 months, and their findings may change the current landscape of obesity pharmacotherapy.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"18 1","pages":"43-48"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9354511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40617282","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: 3
Imeglimin: A New Promising and Effective Weapon in the Treatment of Type 2 Diabetes. 伊米霉素:治疗2型糖尿病的有效新武器。
Pub Date : 2021-11-01 Epub Date: 2021-11-10 DOI: 10.17925/EE.2021.17.2.88
John Doupis, Neoklis Baris, Konstantinos Avramidis

Imeglimin is a novel molecule currently under development for the treatment of type 2 diabetes mellitus, and is the first agent of the 'glimin' class of glucose-lowering medication. It has a unique mechanism of action that targets the three main pathophysiologic components of type 2 diabetes: impaired glucose uptake by muscle tissue, excess hepatic gluconeogenesis and increased β-cell apoptosis. To date, imeglimin has been evaluated in many preclinical and clinical trials and has shown to have notable antihyperglycaemic effects, such as statistically significant reductions in glycated haemoglobin, fasting plasma glucose and other glycaemic parameters. The encouraging tolerability profile, combined with its efficacy, could make it suitable as a monotherapy or in combination with other classes of antidiabetic agents, hopefully in the near future.

依米明是一种新型分子,目前正在开发用于治疗2型糖尿病,是“格米明”类降血糖药物的第一种药物。它具有独特的作用机制,针对2型糖尿病的三个主要病理生理成分:肌肉组织葡萄糖摄取受损,肝脏糖异生过度和β细胞凋亡增加。迄今为止,伊米明已经在许多临床前和临床试验中进行了评估,并显示出显著的抗高血糖作用,例如在统计学上显著降低糖化血红蛋白、空腹血糖和其他血糖参数。令人鼓舞的耐受性,结合其疗效,可能使其适合作为单一治疗或与其他类型的抗糖尿病药物联合使用,希望在不久的将来。
{"title":"Imeglimin: A New Promising and Effective Weapon in the Treatment of Type 2 Diabetes.","authors":"John Doupis,&nbsp;Neoklis Baris,&nbsp;Konstantinos Avramidis","doi":"10.17925/EE.2021.17.2.88","DOIUrl":"https://doi.org/10.17925/EE.2021.17.2.88","url":null,"abstract":"<p><p>Imeglimin is a novel molecule currently under development for the treatment of type 2 diabetes mellitus, and is the first agent of the 'glimin' class of glucose-lowering medication. It has a unique mechanism of action that targets the three main pathophysiologic components of type 2 diabetes: impaired glucose uptake by muscle tissue, excess hepatic gluconeogenesis and increased β-cell apoptosis. To date, imeglimin has been evaluated in many preclinical and clinical trials and has shown to have notable antihyperglycaemic effects, such as statistically significant reductions in glycated haemoglobin, fasting plasma glucose and other glycaemic parameters. The encouraging tolerability profile, combined with its efficacy, could make it suitable as a monotherapy or in combination with other classes of antidiabetic agents, hopefully in the near future.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"17 2","pages":"88-91"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8676108/pdf/touchendo-17-88.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39888373","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: 3
期刊
TouchREVIEWS in endocrinology
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1