Glucagon-like-1 receptor agonists and sodium/glucose cotransporter-2 inhibitors combination—are we exploiting their full potential in a real life setting?

作     者：Maja Cigrovski Berkovic Ines Bilic-Curcic Tomislav Bozek Davorka Herman Mahecic Sanja KlobucarMajanovic Silvija Canecki-Varzic Jelena Andric Srecko Marusic Anna Mrzljak 

作者机构：Faculty of MedicineJ.J.Strossmayer University OsijekOsijek 31000Croatia Department for EndocrinologyDiabetes and Clinical PharmacologyClinical Hospital DubravaZagreb 10000Croatia Department of Kinesiological Anthropology and MethodologyFaculty of KinesiologyUniversity of ZagrebZagreb 10000Croatia Department of Endocrinology and Metabolism DisordersClinical Hospital CenterOsijek 31000Croatia University Clinic for Diabetes“Vuk Vrhovac”Merkur University HospitalZagreb 10000Croatia School of MedicineUniversity of ZagrebZagreb 10000Croatia Department for EndocrinologyDiabetes and MetabolismUniversity Hospital Centre“Sestre milosrdnice”Zagreb 10000Croatia Department for EndocrinologyDiabetes and MetabolismUniversity Hospital Centre RijekaSchool of MedicineUniversity of Rijeka51000 RijekaCroatia Department of MedicineMerkur University HospitalSchool of MedicineUniversity of ZagrebZagreb 10000Croatia 

出 版 物：《World Journal of Diabetes》 (世界糖尿病杂志（英文版）（电子版）)

年 卷 期：2020年第11卷第11期

页      面：540-552页

核心收录：

学科分类：1007[医学-药学(可授医学、理学学位)] 1002[医学-临床医学] 10[医学] 

主　　题：Sodium/glucose cotransporter-2 inhibitors Glucagon-like-1 receptor agonists Type 2 diabetes mellitus Body weight Glycemic control Cardiovascular complications 

摘      要：BACKGROUND The sodium/glucose cotransporter-2 inhibitors(SGLT-2i)and glucagon-like-1 receptor agonists(GLP-1RA)are antidiabetic agents effective both in hemoglobin A1c(HbA1c)reduction(with a low risk of hypoglycemia)and cardiovascular event *** patients with type 2 diabetes,the add-on value of combination therapy of GLP-1RA and an SGLT-2i seems *** To investigate whether the efficacy of GLP-1RA and SGLT-2i combination observed in randomized controlled trials translates into therapeutic benefits in the Croatian population during routine clinical practice and *** We included 200 type 2 diabetes patients with poor glycemic control and analyzed the effects of treatment intensification with(1)GLP-1RA on top of SGLT-2i,(2)SGLT-2i on top of GLP-1RA compared to(3)simultaneous addition of both *** primary study endpoint was the proportion of participants with HbA1c7.0%and/or 5%bodyweight *** outcomes included changes in fasting plasma glucose(FPG),prandial plasma glucose,lowdensity lipoprotein cholesterol,estimated glomerular filtration rate(eGFR),and cardiovascular(CV)incidents assessment over a follow-up period of 12 *** The majority of patients were over 65-years-old,had diabetes duration for more than 10 *** initial body mass index was 39.41±5.49 kg/m2 and HbA1c 8.32±1.26%.Around half of the patients in all three groups achieved target HbA1c below 7%.A more pronounced decrease in the HbA1c seen with simultaneous SGLT-2i and GLP-1RA therapy was a result of higher baseline HbA1c and not the effect of initiating combination *** number of patients achieving FPG below 7.0 mmol/L was significantly higher in the SGLT-2i group(P=0.021),and 5%weight loss was dominantly achieved in the simultaneous therapy group(P=0.044).A composite outcome(reduction of HbA1c below 7%(53 mmol/mol)with 5%weight loss)was achieved in 32.3%of total patients included in the *** 18.2%of patients attained composite outc