糖尿病患者的葡萄糖样-1受体激活剂和囊内镜:一个匹配的队列研究
Tarek Odah1, Asrita Vattikonda2, Mark Stark1
1Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA.
Gastrointestinal endoscopy
|August 2, 2024
概括
类似葡萄糖-1受体激动剂 (GLP-1RAs) 在接受视频囊内镜 (VCE) 的糖尿病患者中显著延迟胃空化. 这导致过境时间更长,并在VCE程序期间增加了不完整的小肠评估.
科学领域:
- 胃肠病学 胃肠病学
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 视频囊内镜 (VCE) 是胃肠道疾病的关键诊断工具.
- 类似葡萄糖-1受体激动剂 (GLP-1RAs) 广泛用于糖尿病和体重管理.
- 众所周知,GLP-1RAs会影响胃肠道的运动,特别是胃排空.
研究的目的:
- 研究GLP-1RA使用对糖尿病患者VCE结局的影响.
- 为了比较GLP-1RAs和对照的糖尿病患者之间的胃过渡时间和小肠评估率.
主要方法:
- 追溯队列研究设计.
- 根据人口统计和糖尿病因素,GLP-1RA使用者与非使用者的1:1匹配.
- 主要结局:胃过境时间;次要结局:小肠评估不完整和小肠过境时间.
主要成果:
- 使用GLP-1RA与显著更长的胃过境时间相关 (99.3分钟与25.3分钟,P<.001).
- 7%的GLP-1RA使用者未能通过胃,而对照组为0% (P = .06).
- 在GLP-1RA组中,不完全的小肠评估显著高于GLP-1RA组 (23.5%对4.4%,P<.01).
结论:
- 使用GLP-1RA会在VCE期间延长胃过境时间.
- 使用GLP-1RA增加了VCE中小肠评估不完整率.
- 需要进一步的研究来制定策略,以减轻GLP-1RAs对VCE的这些影响.
相关概念视频
Glucagon-like Receptor Agonists
312
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...
312
Endoscopic Procedures III: Video Capsule Endoscopy
108
Capsule endoscopy, or wireless or video capsule endoscopy, is a diagnostic procedure for examining the entire gastrointestinal tract. Patients swallow a capsule about the size of a vitamin tablet. The capsule is equipped with a transmitter, a battery, an LED light source, and a color video camera to capture images throughout the gastrointestinal tract. This procedure is particularly useful for diagnosing conditions such as Crohn's disease, ulcerative colitis, tumors, polyps, ulcers,...
108
Dipeptidyl Peptidase 4 Inhibitors
180
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...
180
Oral Hypoglycemic Agents: Glinides
150
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...
150
Hypoglycemia and Glucagon
229
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...
229
Oral Hypoglycemic Agents: α-Glucosidase Inhibitors
168
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...
168


