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库辛病和巨病中帕西里奥提德诱导的高血糖症:临床视角和算法建议
Przemysław Witek1, Marek Bolanowski2, Adam Krętowski3
1Department of Internal Medicine, Endocrinology, and Diabetes, Medical University of Warsaw, Warsaw, Poland.
Frontiers in endocrinology
|December 30, 2024
概括
帕西雷奥提德有效治疗库辛氏病和壮症,但可能导致高血糖症. 这项研究提出了对发表胺诱导的高血糖症的管理算法,优先考虑甲福林,GLP-1,SGLT-2抑制剂和胰岛素.
科学领域:
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
- 代谢障碍 代谢障碍 代谢障碍
背景情况:
- 帕西雷奥提德是一种对库辛病 (CD) 和壮症有效的索马托斯塔丁模拟剂.
- 帕西雷奥提德治疗可能会诱发高血糖症,这是一种影响患者管理的显著副作用.
- 在患有糖尿病或糖尿病前期患者中,高血糖症的风险较高.
研究的目的:
- 审查现有的建议,以管理发胺诱导的高血糖症.
- 提出基于证据的监测和治疗算法,用于CD和壮病患者的高血糖症.
- 定制管理策略,考虑慢性病和心血管风险等并发症.
主要方法:
- 对以前的建议和当前的2型糖尿病指南的文献综述.
- 分析高血糖患病率和治疗响应在CD和acromegaly患者治疗沙利.
- 基于高血糖严重程度和患者风险因素的分层治疗算法的开发.
主要成果:
- 帕西里奥提德诱导的高血糖症发生在~25%的CD患者和~50%的壮症患者中.
- 许多病例可以通过改变生活方式或口服抗糖尿病药物来管理.
- 慢性病患者可能会比壮病患者更频繁和严重地出现血糖干扰.
结论:
- 推使用甲福尔明作为治疗发烧诱导高血糖的第一线疗法.
- 随后的治疗选择包括GLP-1受体激活剂和/或SGLT-2抑制剂,其次是胰岛素.
- 拟议的算法提供了一个结构化的方法来管理与利类药物治疗相关的代谢障碍.
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