Tip 2 diabetes mellitus hastalarında eksenatid kullanımı ile vücut ağırlığı, açlık kan şekeri, lipit profili ve hemoglobin A1C değerlerindeki değişim
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Tekirdağ Namık Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Diabetes mellitus glukoz metabolizmasında kronik bozukluğa bağlı komplikasyonlar ve komorbiditeler ile seyreden dünya genelinde yaygın bir halk sağlığı sorunudur. Hastalarının büyük çoğunluğunu tip 2 diyabet hastaları oluşturmakta ve hem ülkemizde hem de dünyada tip 2 diyabet hastalarının çoğunluğu fazla kilolu yada obezdir. GLP-1 Reseptör agonistleri tip 2 diyabet tedavisinde kullanılan ajanlardandır. Klinik çalışmalarda kilo ve glisemik kontrol üzerinde olumlu etkileri bildirilmiştir. Eksenatid grubun ilk üyesi olup GLP-1 reseptör analoğudur. Doğal GLP-1 ile %53 homoloji gösterir ve DPP-4'e karşı dirençlidir. Çalışmamız günde 2 defa eksenatid kullanımının kilo, HbA1C, açlık plazma glukozu, lipid profili, kan basıncı, ALT, AST değişkenleri üzerindeki etkisini inceledik. Metod: Çalışma Tekirdağ Namık Kemal Üniversitesi Tıp Fakültesi Endokrinoloji polikliniğinde 2014 Ağustos-2021 Ağustos Tarihleri arasında Endokrinoloji ve Metabolizma Hastalıkları Polikliniğinde takipli 199 hastanın verilerinin retrospektif olarak başlangıç anı, 6.ay, 12.ay ve 24. aylarda toplanmasıyla oluşturuldu. Bulgular: Çalışmamızda yer alan 199 hastanın 157'si (%78,9) kadın, 43'ü (%8,4) erkekti. Hastaların yaş ortalamaları 51,93 (±10,15 yıl) olup ortalama tip 2 diyabet tanı süresi ay olarak 105,98 (±68,34 ay) izlendi. Eksenatid kullanım süresi ortalama 16,88 (12±17 ay) olup 6 ay ve altında kullanan hasta sayısı 72 (%36,2), 7 ay ve 12 arası kullanan hasta sayısı 43 (%21,6), 13 ay ve üzeri kullanan hasta sayısı 84 (%42,2) olarak izlendi. Başlangıç anı ortalama değerleri kilo 107,34 ± 19,30 kg, VKİ 41,64 ± 7,47 kg/m2, HbA1C % 7,45 ± 1,50, açlık plazma glukozu 149,41 ± 50,15 mg/dl, sistolik kan basıncı 143,63 ± 17,14 mmhg, diyastolik kan basıncı 88,41 ± 9,13 mmhg, ALT 25,24 ± 16,06 U/L, AST 22,20 ± 11,70 U/L olarak saptandı. 6. ayda kiloda ortalama 7,04 kg düşüş izlendi. 12. ayda düşüşün ortalama 9,62 kg ulaştığı sonrasında da 2 yıl sonuna kadar korunduğu görüldü (p<0,001). 6. ayda ortalama olarak HbA1C'de %0,63 (p<0,001), APG'de 11,88 mg/dl (p<0,001), sistolik kan basıncında 5,84 mmhg (p<0,001), diyastolik kan basıncında 3,9 mmhg (p<0,001), ALT'de 3,62 U/L (p<0,001), AST'de 2,52 U/L (p<0,01) düşüş izlendi. Sonrasında düşüşlerin 2 yıl sonuna kadar korunduğu izlendi. 2 yıl süresince Lipid profili üzerinde istatiksel anlamlı fark saptanmadı. Sonuç: 2 yıl veya daha az süreli eksenatid tedavisi glisemik kontrol, kilo kaybı, hepatik belirteç ve kan basıncı üzerinde iyileştirici etki göstermiştir.
Aim: Diabetes mellitus is a widespread global public health issue characterized by chronic disturbances in glucose metabolism, and the majority of patients are comprised of individuals with type 2 diabetes, many of whom are overweight or obese, both in our country and worldwide. GLP-1 receptor agonists are among the agents used in the treatment of type 2 diabetes. Positive effects on weight and glycemic control have been reported in clinical trials. Exenatide, the first member of the GLP-1 RA class, is an analog of natural GLP-1, exhibiting a 53% homology, and it is resistant to DPP-4 degradation. In our study, we investigated the effects of twice daily exenatide treatment on weight, HbA1C, fasting plasma glucose, lipid profile, blood pressure, ALT and AST values. Methods: The study was conducted by retrospectively collecting data from 199 patients who were followed up at the Endocrinology and Metabolic Diseases Outpatient Clinic between August 2014 and August 2021 at Namık Kemal University School of Medicine. Results: Of the 199 patients included in our study, 157 (78.9%) were female, and 43 (21.6%) were male. The mean age of the patients was 51.93 (±10.15 years), and the mean duration of type 2 diabetes was 105.98 (±68.34 months). The average duration of exenatide use was 16.88 (12±17 months), with 72 (36.2%) patient used for 6 months or less, 43 (21.6%) patient used for 7 to 12 months, and 84 (42.2%) patient used for 13 months or more. Baseline mean values were as follows: weight 107.34 ± 19.30 kg, BMI 41.64 ± 7.47 kg/m2, HbA1C 7.45 ± 1.50%, fasting blood glucose 149.41 ± 50.15 mg/dL, systolic blood pressure 143.63 ± 17.14 mmHg, diastolic blood pressure 88.41 ± 9.13 mmHg, ALT 25.24 ± 16.06 U/L, AST 22.20 ± 11.70 U/L. After 6 months of treatment, there was an average weight loss of 7.04 kg (p<0,001), and by the 12th month, the average weight loss reached 9.62 kg (p<0,001), and this reduction was maintained through 2 years (p<0.001). After 6 months of treatment, there was an average reduction of 0.63% in HbA1C (p<0,001), 11.88 mg/dL in fasting plasma glucose (p<0,001), 5.84 mmHg in systolic blood pressure (p<0,001), 3.9 mmHg in diastolic blood pressure (p<0,001), 3.62 U/L in ALT (p<0,001), and 2.52 U/L in AST (p<0,001). These reductions were maintained through 2 years. No statistically significant difference was found through 2 years in the lipid profile. Conclusion: A 2-year or shorter exenatide treatment has demonstrated an improvement in glycemic control, weight loss, hepatic markers, and blood pressure.
Aim: Diabetes mellitus is a widespread global public health issue characterized by chronic disturbances in glucose metabolism, and the majority of patients are comprised of individuals with type 2 diabetes, many of whom are overweight or obese, both in our country and worldwide. GLP-1 receptor agonists are among the agents used in the treatment of type 2 diabetes. Positive effects on weight and glycemic control have been reported in clinical trials. Exenatide, the first member of the GLP-1 RA class, is an analog of natural GLP-1, exhibiting a 53% homology, and it is resistant to DPP-4 degradation. In our study, we investigated the effects of twice daily exenatide treatment on weight, HbA1C, fasting plasma glucose, lipid profile, blood pressure, ALT and AST values. Methods: The study was conducted by retrospectively collecting data from 199 patients who were followed up at the Endocrinology and Metabolic Diseases Outpatient Clinic between August 2014 and August 2021 at Namık Kemal University School of Medicine. Results: Of the 199 patients included in our study, 157 (78.9%) were female, and 43 (21.6%) were male. The mean age of the patients was 51.93 (±10.15 years), and the mean duration of type 2 diabetes was 105.98 (±68.34 months). The average duration of exenatide use was 16.88 (12±17 months), with 72 (36.2%) patient used for 6 months or less, 43 (21.6%) patient used for 7 to 12 months, and 84 (42.2%) patient used for 13 months or more. Baseline mean values were as follows: weight 107.34 ± 19.30 kg, BMI 41.64 ± 7.47 kg/m2, HbA1C 7.45 ± 1.50%, fasting blood glucose 149.41 ± 50.15 mg/dL, systolic blood pressure 143.63 ± 17.14 mmHg, diastolic blood pressure 88.41 ± 9.13 mmHg, ALT 25.24 ± 16.06 U/L, AST 22.20 ± 11.70 U/L. After 6 months of treatment, there was an average weight loss of 7.04 kg (p<0,001), and by the 12th month, the average weight loss reached 9.62 kg (p<0,001), and this reduction was maintained through 2 years (p<0.001). After 6 months of treatment, there was an average reduction of 0.63% in HbA1C (p<0,001), 11.88 mg/dL in fasting plasma glucose (p<0,001), 5.84 mmHg in systolic blood pressure (p<0,001), 3.9 mmHg in diastolic blood pressure (p<0,001), 3.62 U/L in ALT (p<0,001), and 2.52 U/L in AST (p<0,001). These reductions were maintained through 2 years. No statistically significant difference was found through 2 years in the lipid profile. Conclusion: A 2-year or shorter exenatide treatment has demonstrated an improvement in glycemic control, weight loss, hepatic markers, and blood pressure.
Açıklama
Tıp Fakültesi, İç Hastalıkları Ana Bilim Dalı, İç Hastalıkları Bilim Dalı
Anahtar Kelimeler
Endokrinoloji ve Metabolizma Hastalıkları, Endocrinology and Metabolic Diseases ; İç Hastalıkları
