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首页> 外文期刊>Endocrinology, Diabetes & Metabolism >Lixisenatide in type 1 diabetes: A randomised control trial of the effect of lixisenatide on post‐meal glucose excursions and glucagon in type 1 diabetes patients
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Lixisenatide in type 1 diabetes: A randomised control trial of the effect of lixisenatide on post‐meal glucose excursions and glucagon in type 1 diabetes patients

机译：1型糖尿病患者：Lixisenatide对1型糖尿病患者的膳食葡萄糖偏移和胰高血糖素的随机对照试验

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Aims The GLP1 agonist lixisenatide is glucagonostatic and reduces post‐prandial blood glucose (PPBG) in type 2 diabetes. This study investigates its impact in type 1 diabetes (T1D). Methods In a blinded, crossover trial, 25 patients with T1D were randomised to 4?weeks adjunctive treatment with lixisenatide (L) or placebo (P), with a 4‐week washout period. The primary outcome was percentage of 3?hours PPBG in target (4‐10?mmol/L) assessed by CGM before and after treatment. Participants also underwent post‐treatment standardised mixed meal test (MMT, n?=?25) and hyperinsulinaemic hypoglycaemic clamp (n?=?15). Results PPBG CGM readings in target were similar between L vs P (Mean %?±?SE, breakfast 45.4?±?6.0 vs 44.3?±?6.0, P =?.48, lunch 45.5?±?5.8 vs 50.6?±?5.3, P =?.27 and dinner 43.0?±?6.7 vs 47.7?±?5.6, P =?.30). HbA1C was similar between L vs P (64.7?±?1.6 vs 64.1?±?1.6?mmol/mol, P =?.30). Prandial insulin fell after lixisenatide (dose change ?0.7?±?0.6 vs +2.4?±?0.7?units/d, P =?.004), but basal insulin dose was similar between groups. The post‐MMT glucose area under the curve (AUC) was lower with L than P (392.0?±?167.7 vs 628.1?±?132.5?mmol/L?×?min, P ?.001), as was the corresponding glucagon AUC (140.0?±?110.0 vs 304.2?±?148.2?nmol/L?×?min, P ?.001). Glucagon and counter‐regulatory hormone values at a blood glucose of 2.4?mmol/L during the hypoglycaemic clamp were similar between L and P. Conclusion In T1D, PPBG values were not altered by adjunctive lixisenatide although prandial insulin dose fell. Glucose and glucagon level during an MMT were significantly lower after lixisenatide, without affecting counter‐regulatory response during hypoglycaemia.
机译：AIMS GLP1激动剂Lixisenatide是胰岛素苷，可减少2型糖尿病的伪造后血糖（PPBG）。本研究调查其对1型糖尿病（T1D）的影响。方法在盲化，交叉试验中，25例T1D患者随机分为4周，用Lixisenatide（L）或安慰剂（P）进行辅助处理，其中洗涤期为4周。主要结果是CGM在治疗前后评估的靶标（4-10〜Mmol / L）中的3？小时PPBG的百分比。参与者还经历了后处理后标准化混合膳食测试（MMT，N？= 25）和超胰岛素血症低血基纤维夹（N？=？15）。结果靶标中的ppbg cgm读数在l vs p之间相似（平均值？±ηse，早餐45.4？±6.0与44.3？±6.0，p = ?. 48，午餐45.5？±5.8 vs 50.6？±5.8 vs 50.6？ 5.3，p = ?. 27和晚餐43.0？±6.7 vs 47.7？±5.6，p =？30）。 HBA1C在L VS P之间相似（64.7？±1.6 vs 64.1？±1.6？mmol / mol，p = 30）。乳酸酐（剂量变化后）折叠胰岛素（0.7≤0.6，+2.4°±0.7〜1°/ D，P =α.004），但基团之间是相似的基础胰岛素剂量。曲线（AUC）下的MMT葡萄糖面积较低，L比P（392.0≤α±167.7 Vs 628.1〜±132.5？mmol / l？×α？min，p <Δ001），与相应的相应Glucagon Auc（140.0？±110.0 Vs 304.2？±148.2？Nmol / L？×α？min，p <001）。胰高血糖素和反调节激素值为2.4的血糖，在低血糖夹持过程中的血糖/ L之间的L和P.结论在T1D中，辅助胰岛素剂量下降，PPBG值没有通过辅助升索改变。在Lixisenatide后，MMT期间的葡萄糖和胰高血糖素水平显着降低，而不会影响低血糖期间的反调节反应。

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