The Promise of Adjunct Medications in Improving Type 1 Diabetes Outcomes: Glucagon-Like Peptide Receptor Agonists.

IF 4.1 Q2 ENDOCRINOLOGY & METABOLISM
Sujatha Seetharaman, Eda Cengiz
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Abstract

Type 1 diabetes (T1D) necessitates lifelong insulin therapy due to the autoimmune destruction of insulin-producing pancreatic beta cells. Despite advancements in diabetes technology and insulin formulations, maintaining optimal glycemic outcomes remains challenging in these individuals. Obesity, accompanied by insulin resistance, is common not only in type 2 diabetes (T2D) but also in many individuals with T1D. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), approved for T2D and obesity, are now being explored for off-label use in individuals with T1D. This review examines their efficacy, safety, and potential benefits in T1D management. We reviewed articles published up to May 2024 from databases like PubMed and Scopus, mainly focusing on human studies of GLP-1 RAs in T1D, as well as cardiorenal and metabolic outcomes in individuals with T2D and obesity. Semaglutide and other GLP-1 RAs showed significant improvements in glycemic outcomes, hemoglobin A1c levels, reduced insulin doses, and notable weight loss. Studies in individuals with obesity and T2D showed significant improvements in lipid profile and offered cardiorenal protection. Common side effects include gastrointestinal issues, and while some studies reported hypoglycemia, hyperglycemia, and ketosis, others did not. Despite these challenges, GLP-1 RAs offer significant therapeutic benefits, making them a promising adjunct to insulin therapy for improving clinical outcomes in T1D management.

辅助药物改善1型糖尿病预后的前景:胰高血糖素样肽受体激动剂。
1型糖尿病(T1D)需要终身胰岛素治疗,因为自身免疫破坏产生胰岛素的胰腺β细胞。尽管糖尿病技术和胰岛素配方取得了进步,但在这些个体中保持最佳血糖结果仍然具有挑战性。肥胖,伴随着胰岛素抵抗,不仅在2型糖尿病(T2D)中很常见,在许多T1D患者中也很常见。胰高血糖素样肽-1受体激动剂(GLP-1 RAs)已被批准用于T2D和肥胖,目前正在探索在T1D患者的说明书外使用。本文综述了它们在T1D治疗中的有效性、安全性和潜在益处。我们回顾了截至2024年5月PubMed和Scopus等数据库中发表的文章,主要关注GLP-1 RAs在T1D中的人体研究,以及T2D和肥胖患者的心肾和代谢结局。Semaglutide和其他GLP-1 RAs显示出血糖结局、血红蛋白A1c水平、胰岛素剂量减少和显著体重减轻的显著改善。对肥胖和T2D患者的研究显示,血脂水平有显著改善,并提供心肾保护。常见的副作用包括胃肠道问题,虽然一些研究报告了低血糖、高血糖和酮症,但其他研究没有报告。尽管存在这些挑战,GLP-1 RAs提供了显著的治疗益处,使其成为胰岛素治疗的有希望的辅助治疗,以改善T1D治疗的临床结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Diabetes Science and Technology
Journal of Diabetes Science and Technology Medicine-Internal Medicine
CiteScore
7.50
自引率
12.00%
发文量
148
期刊介绍: The Journal of Diabetes Science and Technology (JDST) is a bi-monthly, peer-reviewed scientific journal published by the Diabetes Technology Society. JDST covers scientific and clinical aspects of diabetes technology including glucose monitoring, insulin and metabolic peptide delivery, the artificial pancreas, digital health, precision medicine, social media, cybersecurity, software for modeling, physiologic monitoring, technology for managing obesity, and diagnostic tests of glycation. The journal also covers the development and use of mobile applications and wireless communication, as well as bioengineered tools such as MEMS, new biomaterials, and nanotechnology to develop new sensors. Articles in JDST cover both basic research and clinical applications of technologies being developed to help people with diabetes.
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