最新研究 | 长期使用利拉鲁肽反而会使二型糖尿病患者血糖升高
利拉鲁肽是一种用于治疗二型糖尿病的GLP-1受体激动剂,可模拟肠促胰岛素作用以促进胰岛素分泌;然而,一项发表于《Cell Metabolism》的研究指出,长期使用该药可能导致胰岛β细胞功能耗竭,反而引起血糖升高。
关键要点
- 利拉鲁肽在短期使用中能有效降低二型糖尿病患者的血糖水平。
- 长期使用利拉鲁肽可能使胰岛β细胞过度刺激而功能衰竭,导致胰岛素分泌减少。
- 该研究基于移植了人源胰岛β细胞的小鼠模型,持续给药250天后观察到血糖升高的趋势。
- 研究者建议在制定长期治疗方案时需谨慎评估GLP-1类似物的潜在风险。
- 该发现对临床用药、患者管理和药物研发具有重要参考价值。
小白老师说:Liraglutide is a drug used to lower blood sugar levels for people with type 2 diabetes. However, a new study suggests that long-term use of the medication may do just the opposite.**
利拉鲁肽在临床上用于降低二型糖尿病患者的血糖水平,然而,一项发表在期刊Cell Metabolism上的新的研究表明,长期使用该药反而会使患者的血糖水平升高。
Type 2 Diabetes: Long-term Liraglutide Use May Raise Blood Sugar Levels
Written by Honor Whiteman
Published: Friday 12 February 2016
Published in the journal Cell Metabolism, the study reveals that over time, liraglutide (brand name Victoza) can exhaust insulin-producing beta cells in a way that leads to a rise in blood sugar levels.
The findings may have important implications for patients with type 2 diabetes, for whom liraglutide may be recommended if other medications have failed.
Approved by the US Food and Drug Administration (FDA) for the treatment of type 2 diabetes in 2010, liraglutide is a once-daily injection that is to be used alongside diet and exercise to help lower blood sugar levels.
Liraglutide belongs to a class of drugs known as incretin mimetics. It simulates the effects of an incretin called human-glucagon-like peptide-1 (GLP-1), which is a hormone expressed in pancreatic beta cells that increases the secretion of insulin.
According to the researchers of this latest study - including Per-Olof Berggren, PhD, of the Department of Molecular Medicine and Surgery at the Karolinska Institutet in Sweden - there is strong evidence that liraglutide is effective for type 2 diabetes, with studies showing that it leads to an initial reduction in blood sugar.

However, Prof. Berggren and colleagues note that few studies have investigated the long-term effects of incretin therapy.
Liraglutide reduced insulin secretion in mice over time
To address this research gap, the team analyzed the effects of liraglutide in mice that had been transplanted with human insulin-producing beta cells in the anterior chamber of the eye.
For 250 days, the mice were given a daily dose of liraglutide, and the team monitored how the drug affected the transplanted beta cells.
As found in previous research, the team identified an initial improvement in the insulin-producing beta cells. Over time, however, the drug appeared to exhaust the beta cells, leading to a reduction in insulin secretion that may cause a rise in blood sugar.
The researchers say their study has made an “important discovery,” and they believe the findings are of significant value to clinicians, patients and the pharmaceutical industry.
Prof. Berggren says:
"We […] need to take these results into account before prescribing blood-sugar suppressing GLP-1 analogues when planning long-term treatment regimens for patients.
Our study also shows in general how to carry out in vivo studies of the long-term effects of drugs on human insulin-producing cells, which should be extremely important to the drug industry."
Last month, Medical News Today reported on a study suggesting that sleeping in at the weekend may lower the risk of type 2 diabetes.
Written by Honor Whiteman
常见问题
利拉鲁肽还能用于二型糖尿病治疗吗?
利拉鲁肽仍被FDA批准用于二型糖尿病治疗,但新研究提示长期使用可能存在β细胞功能耗竭风险,应在医生指导下权衡利弊。
这项研究是否意味着所有患者都会出现血糖升高?
研究主要基于动物模型,并未在大规模人群中验证;个体反应存在差异,不能一概而论。
什么是GLP-1受体激动剂?
GLP-1受体激动剂是一类模拟人体GLP-1激素作用的药物,通过促进胰岛素分泌、抑制胰高血糖素释放来降低血糖。
参考资料
Type 2 Diabetes: Long-term Liraglutide Use May Raise Blood Sugar Levels
https://www.cell.com/cell-metabolism/fulltext/S1550-4131(16)00028-7原始研究发表于Cell Metabolism期刊,由Karolinska Institutet团队完成
FDA Approval of Liraglutide (Victoza) for Type 2 Diabetes
美国FDA于2010年批准利拉鲁肽用于二型糖尿病治疗