Effect of Liraglutide on Patients with Type 2 Diabetes in Real Practice: Experience from A Regional Hospital

第二型糖尿病病人使用胰妥善成效評估

王寶妹(Bao-Mei Wang) ； 馬文雅(Wen-Ya Ma) ； 蘇景傑(Ching-Chieh Su)

《內科學誌》 31卷3期 (2020/06) Pp. 202-209

https://doi.org/10.6314/JIMT.202006_31(3).08

摘要

Liraglutide is a new injectable anti-diabetic medicine. It can lower blood glucose and also result in a neutral or lowered body weight. However, the interaction of changes in blood glucose and body weight is not clear. This study is a retrospective chart review study. Patients with type 2 diabetes who initiated liraglutide therapy from 1, Sep. 2016 to 30 Nov. 2016 were enrolled. We assessed the change in blood glucose and body weight after liraglutide treatment. Results: The study found that most patients had lower A1C and body weight simultaneously but no relationship between body weight and blood glucose change was found. In multivariable linear regression models, variables such as male, diabetes duration, and baseline A1C are all positively correlated and numbers of anti-diabetic drugs is negatively correlated to the change of A1C. Age is positively correlated and the number of anti-diabetic drugs is negatively correlated to body weight change. We found that liraglutide could decrease body weight and blood glucose. However, there is no relationship between the glucose reduction and body weight lowering effects. In respect of glucose reduction, male patients with longer diabetes durations, using less oral anti-diabetic drugs or higher baseline A1C are good candidates for liraglutide treatment. In respect of body weight reduction, younger patients with more anti-diabetic drugs are less likely to lose their body weight.

關鍵字

Liraglutide ； Type 2 diabetes ； Body weight change

並列摘要

胰妥善為一種較新型的注射型降血糖藥物。它除了降血糖以外甚至有降體重的效果。目前對於類升糖素胜肽-1受體的促效劑使用上作用於血糖和體重變化之間的交互作用目前還不是很清楚。本研究是病歷回顧研究，回顧從2016年9月1日至2016年11月30日期間，有使用胰妥善（一種類升糖素胜肽-1受體的促效劑）的第二型糖尿病病人列入評估。回顧其使用胰妥善後的血糖及體重變化。其中大部份的病人糖化血色素和體重同時下降，但體重及糖化血色素下降幅度之間並無相關。在多元線性回歸模型分析變數發現，第二型糖尿病病人使用胰妥善治療後糖化血色素的下降幅度和某些變數，例如男性、糖尿病罹病時間長短及初始糖化血色素值，呈現正相關；但和降血糖藥物數目多寡呈現負相關。至於治療後體重變化，則與使用年齡呈正相關，但降血糖藥物數目呈負相關。我們發現胰妥善（liraglutide）可以使血糖及體重下降，然而血糖下降幅度及體重下降幅度之間並無呈現出相關性。關於血糖下降此研究發現、男性病患、糖尿病發病時間較長、相對少使用降血糖藥物或初期糖化血色素高的病患是適合使用胰妥善的候選人。在體重下降方面，則是年輕人合併使用降血糖藥物數目多者，其體重下降機會較低。