葡萄糖类-1受体激剂在糖尿病患者上部内镜检查期间不会增加吸收
Trevor S Barlowe1, Chelsea Anderson2, Robert S Sandler3
1Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina.
概括
葡萄糖类-1-受体激动剂 (GLP1-RAs) 在2型糖尿病患者上部内镜检查期间不会增加吸血或肺部并发症的风险. 这项研究发现,与其他常见的糖尿病药物相比,风险没有增加.
科学领域:
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 类似葡萄糖-1受体激动剂 (GLP1-RAs) 可能会延迟胃空化.
- 有限的数据存在GLP1-RA安全性在周边程序设置,如上部内镜.
- 吸收风险是接受内镜手术的患者的一个担忧.
研究的目的:
- 评估使用GLP1-RAs进行上部内镜检查的患者吸血和相关肺部并发症的风险.
- 为了比较GLP1-RA使用者与使用二二酶4抑制剂 (DPP4is) 和慢性阿片类药物的使用者.
主要方法:
- 使用全国性商业索赔数据库 (2005-2021) 进行回顾性队列研究.
- 包括18-64岁的2型糖尿病患者的6,806,046个上部内镜手术.
- 在GLP1-RA使用者和对照组之间,在内镜检查后14天内比较吸气和肺部事件,并对混因素进行调整.
主要成果:
- 肺内镜后的肺部不良事件很少发生 (每10,000次手术中6-25次).
- 与DPP4i使用相比,GLP1-RA使用与吸入,吸入肺炎,肺炎或呼吸衰竭的风险不高.
- 与慢性阿片类药物使用相比,GLP1-RA使用显示肺炎和呼吸衰竭的风险较低或相似.
结论:
- 在2型糖尿病患者上部内镜检查后,GLP1-RA的使用与增加的肺部并发症无关.
- 这些发现表明,GLP1-RAs在上部内镜的周边手术环境中是安全的.
- 与DPP4i用户相比,GLP1-RA用户的吸收风险没有增加.
相关概念视频
Glucagon-like Receptor Agonists
318
Incretins include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which stimulate insulin secretion post-meals. In type 2 diabetes, GIP's efficacy is reduced, making GLP-1 a viable drug target. GIP originates from preproGIP.
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
318
Oral Hypoglycemic Agents: α-Glucosidase Inhibitors
173
α-glucosidase inhibitors, including acarbose (Precose), miglitol (Glyset), and voglibose (Voglib) (primarily available in Asia), are drugs that control blood sugar levels by delaying the digestion of starch and disaccharides. They achieve this by inhibiting α-glucosidase enzymes in the intestine, which slow the absorption of carbohydrates in the intestine, which in turn leads to a prolonged release of the glucoregulatory hormone GLP-1 from intestinal L-cells.
Acarbose and miglitol are...
Acarbose and miglitol are...
173
Hypoglycemia and Glucagon
257
Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
257
Dipeptidyl Peptidase 4 Inhibitors
181
Dipeptidyl peptidase 4 (DPP-4) is a serine protease widely distributed in the body. It's involved in the inactivation of GLP-1 and GIP hormones, which are crucial for insulin regulation. DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina), and vildagliptin (Galvus), help increase the proportion of active GLP-1, enhancing insulin secretion. These inhibitors work by competitively binding to DPP-4. This binding causes a...
181
Oral Hypoglycemic Agents: Glinides
153
Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively...
153
Oral Hypoglycemic Agents: Biguanides and Glitazones
192
Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood...
192

![Assessment of Gastric Emptying in Non-obese Diabetic Mice Using a [13C]-octanoic Acid Breath Test](/_next/image?url=https%3A%2F%2Fcloudfront.jove.com%2FCDNSource%2Fteasers%2F50301.jpg&w=3840&q=50)
