LaDonna Clark is director of clinical education in the Physician Assistant Studies Program at Gardner-Webb University in Boiling Springs, N.C. The author has disclosed no potential conflicts of interest, financial or otherwise.
JAAPA. 2024 Apr 1;37(4):1-4. doi: 10.1097/01.JAA.0001007388.97793.41. Epub 2024 Mar 26.
Type 2 diabetes mellitus (T2DM) is a chronic medical condition affecting millions of individuals worldwide. The burden of disease is significant, as demonstrated by high morbidity and mortality and billions of healthcare dollars spent. The pathophysiology of T2DM is complex, with eight primary deficits. In recent years, an increased focus has been placed on incretin hormones, such as glucagon-like peptide-1 (GLP-1) for its glucose-lowering benefits. Several FDA-approved short-acting and long-acting GLP-1 receptor agonists (GLP-1 RAs) are available in the United States for the treatment of T2DM. These are liraglutide, exenatide, dulaglutide, and semaglutide, all administered via subcutaneous injection. Semaglutide is also available in an oral formulation. A newer dual glucose-dependent insulinotropic peptide (GIP) and GLP-1 RA, tirzepatide, is available as a subcutaneous injectable. In addition to improving glycemic control, GLP-1 RAs have been shown to lower total body weight, BP, and cholesterol as well as to improve renal function and beta-cell proliferation. These agents should be considered in every patient with T2DM due to their substantial clinical benefits and potential to help reduce disease burden.
2 型糖尿病(T2DM)是一种影响全球数百万人的慢性疾病。其疾病负担巨大,表现为高发病率和死亡率以及数十亿美元的医疗保健支出。T2DM 的病理生理学非常复杂,存在八种主要缺陷。近年来,人们越来越关注肠促胰岛素激素,如胰高血糖素样肽-1(GLP-1),因为它具有降低血糖的作用。美国有几种已获 FDA 批准的短效和长效 GLP-1 受体激动剂(GLP-1 RAs)可用于治疗 T2DM。这些药物包括利拉鲁肽、艾塞那肽、度拉糖肽和司美格鲁肽,均通过皮下注射给药。司美格鲁肽也有口服制剂。一种新型的双重葡萄糖依赖性胰岛素促分泌肽(GIP)和 GLP-1 RA,替西帕肽,作为一种可皮下注射的药物。除了改善血糖控制外,GLP-1 RAs 还被证明可以降低总体体重、血压和胆固醇,改善肾功能和β细胞增殖。由于这些药物具有显著的临床益处,并有可能有助于减轻疾病负担,因此应考虑在每个 T2DM 患者中使用。