胰高血糖素样肽-1受体激动剂治疗青少年2型糖尿病。

Casey Berman, Alaina P Vidmar, Lily C Chao
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引用次数: 0

摘要

胰高血糖素样肽-1受体激动剂(GLP-1RAs)在2型糖尿病和肥胖的治疗中获得了广泛的应用。与几种导致体重增加的抗糖尿病药物不同,GLP-1RAs不仅能降低血红蛋白A1c,还能促进体重减轻。虽然有大量证据支持其在成人中的安全性和有效性,但儿科临床试验数据仅在最近几年才出现。这篇综述将讨论小儿2型糖尿病的有限治疗方案和GLP-1RAs的作用机制,因为它涉及与2型糖尿病、肥胖及其相关合并症相关的生理途径。评估利拉鲁肽、艾塞那肽、西马鲁肽和杜拉鲁肽治疗儿童2型糖尿病和肥胖症的儿科试验的结果将被仔细研究,包括与成人研究的差异。最后,将讨论在青少年中扩大GLP-1RA获取的潜在障碍和策略。未来的研究需要确定GLP-1RAs对心脏和肾脏的保护作用是否适用于年轻发病的2型糖尿病。
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Glucagon-like Peptide-1 Receptor Agonists for the Treatment of Type 2 Diabetes in Youth.

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have gained traction for the management of type 2 diabetes and obesity. Unlike several classes of antidiabetic medications that contribute to weight gain, GLP-1RAs not only reduce haemoglobin A1c, but also promote weight loss. While there is a large body of evidence supporting its safety and efficacy in adults, paediatric clinical trial data have only emerged in recent years. This review will discuss the limited treatment options for paediatric type 2 diabetes and the mechanism of action of GLP-1RAs as it pertains to physiological pathways relevant for type 2 diabetes, obesity and their related comorbidities. The outcomes of paediatric trials evaluating liraglutide, exenatide, semaglutide and dulaglutide in paediatric type 2 diabetes and obesity will be closely examined, including differences compared with adult studies. Finally, potential barriers and strategies to expanding GLP-1RA access in adolescents will be discussed. Future studies are needed to determine if the cardio-and renal-protective benefits of GLP-1RAs apply to youth-onset type 2 diabetes.

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