百泌达长中期应用病例分享.ppt

百泌达不良反应以消化道症状为主， 多数不严重，可以耐受，并逐渐缓解 百泌达很少出现低血糖反应 百泌达导致胰腺炎的比例并未增多 体会6 小结 百泌达 直击餐后，有效降糖 减少进食，减轻胰岛素抵抗，持续减重 多重调节代谢紊乱 安全性好 谢 谢 ！ 一项纳入30名研究对象的随机试验，30名予以二甲双胍联合噻唑烷二酮降糖治疗的患者被随机分为两组，添加使用百泌达组17人，添加安慰剂组13人，治疗2周后，治疗前后对研究对象进行24小时血糖监测。从这张幻灯片的图显示治疗2周后，百泌达组和安慰剂组的24小时血糖监测的对比，结果显示，百泌达有效降低三餐后血糖。 * AMIGO和开放性延伸研究3年的数据表明，在使用百泌达12周时，糖化血红蛋白降低1.1%，在坚持使用百泌达第3年，糖化血红蛋白仍可降低1%，理想控制血糖长达3年，提示百泌达降糖效果持久有效。 * DeFronzo Diabetes Care 2005 * Key Points 胰岛素原/胰岛素比值是β 细胞功能的标志物，降低胰岛素原/胰岛素比值提示保护β 细胞功能。艾塞那肽治疗30周即已显著保护β 细胞功能。 Notes 艾塞那肽10ug治疗30周较安慰剂组显著降低胰岛素原/胰岛素比值（P0.001）， DISCUSSION: The fasting proinsulin-to-insulin ratio is a marker of β -cell function. A decrease in this ratio is suggestive of an improvement in β -cell function From baseline to Week 30, proinsulin-to-insulin ratios were reduced ?0.03% for 5 μg and -0.17% (P0.001) for 10 μg compared with placebo STUDY BACKGROUND: 112 – 30-week triple-blind, phase 3 study; patients with type 2 diabetes randomized to placebo or 5 or 10 μg exenatide BID w/MET, ITT n=336 Key Points 艾塞那肽治疗3年，HOMA-B指数持续显著改善，提示艾塞那肽持续保护β 细胞功能 Notes 艾塞那肽治疗3年HOMA-B指数显著改善，从第一年52%增加至第三年70%（P 0.0001 ） 艾塞那肽治疗3年HOMA-S也指数显著改善 DISCUSSION Chart shows mean increases of HOMA-B from baseline of 52% after 1 year (66%), 2 years (64%), and 3 years (70%) of exenatide treatment From a baseline HOMA-B of 52%, patients exposed to 3 years of exenatide had HOMA-B of 70%, an improvement of 17% (P 0.0001 from baseline) HOMA-S change from baseline was insignificant after 3 years of exenatide treatment BACKGROUND Patients with T2DM treated with MET and/or SFU were randomized to receive placebo or exenatide in the original placebo-controlled, double blind, Phase 3, randomized trials and received exenatide in the subsequent open-label extensions HOMA-B analysis was carried out on a subgroup of patients who received MET or SFU and exposure to exenatide for 3 years (n=92) Homeostasis Model Assessment (HOMA-B) is a computer-generated model consisting of nonlinear equations that estimates steady stat