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首页> 外文期刊>Diabetes care >Efficacy and Safety of Short- and Long-Acting Glucagon-Like Peptide 1 Receptor Agonists on a Background of Basal Insulin in Type 2 Diabetes: A Meta-analysis
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Efficacy and Safety of Short- and Long-Acting Glucagon-Like Peptide 1 Receptor Agonists on a Background of Basal Insulin in Type 2 Diabetes: A Meta-analysis

机译：短血糖葡萄糖样肽1受体激动剂在2型糖尿病患者的基础胰岛素背景下的疗效和安全性：META分析

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PURPOSE To compare the efficacy and safety of short- and long-acting glucagon-like peptide 1 receptor agonists (GLP-1 RAs), both used in combination with basal insulin, in patients with type 2 diabetes. DATA SOURCES AND STUDY SELECTION Randomized controlled trials comparing the coadministration of short- or long-acting GLP-1 RAs and basal insulin with basal insulin +/- placebo were identified (PubMed search). Of 974 identified publications, 14 clinical trials were included. Eight trials examined short-acting and six long-acting GLP-1 RAs. DATA EXTRACTION AND DATA SYNTHESIS Differences in HbA(1c), fasting plasma glucose, body weight, and adverse events were compared between studies using short- or long-acting GLP-1 RAs by random-effects meta-analysis. LIMITATIONS There were relatively small numbers of available publications, some heterogeneity regarding protocols, and differences in the GLP-1 RA compound used. CONCLUSIONS Long-acting GLP-1 RAs more effectively reduced HbA(1c)( increment -6 mmol/mol [95% CI -10; -2],P= 0.007), fasting plasma glucose ( increment -0.7 mmol/L [-1.2; -0.3],P= 0.007), and body weight ( increment -1.4 kg [-2.2; -0.6],P= 0.002) and raised the proportion of patients achieving an HbA(1c)target <7.0% (<53 mmol/mol) (P= 0.03) more than the short-acting ones. Patients reporting symptomatic (P= 0.048) but not severe (P= 0.96) hypoglycemia were fewer with long- versus short-acting GLP-1 RAs added to insulin. A lower proportion of patients reported nausea (-52%,P< 0.0001) or vomiting (-36%,P= 0.0002) with long-acting GLP-1 RAs. Overall, GLP-1 RAs improved HbA(1c), fasting plasma glucose, and body weight when added to basal insulin. However, long-acting GLP-1 RAs were significantly more effective for glycemic and body weight control and displayed better gastrointestinal tolerability.
机译：目的，比较患有2型糖尿病患者的短型胰高血糖素样肽1受体激动剂（GLP-1RAS）的疗效和安全性，两者与基础胰岛素组合使用。鉴定了数据来源和研究选择随机对照试验比较短或长效GLP-1 RAS和基础胰岛素+/-安慰剂的基础胰岛素的共同分配（PubMed Search）。在974个鉴定的出版物中，包括14项临床试验。八项试验检查了短作用和六个长效的GLP-1 Ras。通过随机效应元分析使用短或长效GLP-1 Ras的研究比较了HBA（1C），禁食血浆葡萄糖，体重和不良事件的数据提取和数据合成差异。限制数量相对较少的可用出版物，一些关于方案的异质性，并且使用的GLP-1 RA化合物的差异。结论长效GLP-1 RA更有效地减少HBA（1C）（增量-6mmol / mol [95％CI -10; -2]，P = 0.007），禁食等离子体葡萄糖（递增-0.7mmol / L [ - 1.2; - 0.3]，p = 0.007）和体重（增量-1.4 kg [-2.2; -0.6]，p = 0.002）并提高了实现HBA（1c）靶标的患者的比例<7.0％（<53 mmol / mol）（p = 0.03）比短作用。报告症状的患者（P = 0.048）但不严重（p = 0.96）低血糖症较少，较少，与胰岛素添加到胰岛素中的长效。较低比例的患者报告了恶心（-52％，P <0.0001）或呕吐（-36％，P = 0.0002），具有长效GLP-1 Ras。总体而言，GLP-1 RAS改善了HBA（1C），禁食血浆葡萄糖和体重时添加到基底胰岛素时。然而，长效GLP-1 Ras对血糖和体重控制显着更有效，并且显示出更好的胃肠道耐受性。

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