严重的糖尿病酸性酸症与在提尔泽帕提德开始后降低胰岛素剂量有关
Ei Thinzar Aung1, Thinzar Min2, Ye Thurein Mon3
1Diabetes Unit, Swansea Bay University Health Board, Port Talbot, UK Ei.Aung@wales.nhs.uk.
BMJ case reports
|March 9, 2026
概括
在胰岛素治疗的2型糖尿病中,提尔泽帕提德的启动可能会导致严重的糖尿病酸性糖尿病 (DKA). 患者需要教育病假规则和一致的基础胰岛素使用,以防止DKA在治疗期间.
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:
- 蒂尔泽帕提德是一种新型的双双依赖葡萄糖的胰岛素型多 (GIP) 和葡萄糖类-1 (GLP-1) 受体激动剂,用于治疗2型糖尿病.
- 接受胰岛素治疗的2型糖尿病患者有代谢并发症的风险.
- 糖尿病酸症 (DKA) 是糖尿病的一种严重并发症,需要及时治疗.
研究的目的:
- 报告患有2型糖尿病 (T2DM) 的患者患有严重的糖尿病酸 (DKA) 病例,该病例始于 Tirzepatide.
- 强调患者教育有关病日管理和在提尔泽帕提德治疗期间继续使用胰岛素的重要性.
主要方法:
- 一个50多岁的男性患者的病例报告,患有T2DM,正在接受胰岛素治疗.
- 开始治疗蒂尔泽帕提德每周2.5毫克.
- 胃肠道症状和血糖控制的临床监测.
- 评估代谢状态,包括酸平衡,高血糖和症.
主要成果:
- 患者在开始服用蒂尔泽帕提德15天后出现了严重的DKA,具有高阴离子间隙代谢酸性化,明显的高血糖症和症.
- 症状包括严重的腹痛,恶心和吐,导致脱水.
- 患者在入院前减少了基础胰岛素剂量,因为害怕低血糖.
结论:
- 在胰岛素治疗的T2DM患者中启动蒂尔泽帕提德需要加强病假规则.
- 基础胰岛素的持续治疗对于在提尔泽帕提德治疗期间预防DKA至关重要.
- 密切监测胃肠道副作用和代谢去补偿是非常重要的.
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