- Keywords
- semaglutid,
- MeSH
- Administration, Oral MeSH
- Safety MeSH
- Diabetes Mellitus, Type 2 drug therapy MeSH
- Exenatide administration & dosage MeSH
- Sodium-Glucose Transporter 2 Inhibitors administration & dosage MeSH
- Glucagon-Like Peptide 1 agonists MeSH
- Glycated Hemoglobin analysis drug effects MeSH
- Weight Loss drug effects MeSH
- Hypoglycemic Agents * administration & dosage pharmacology adverse effects MeSH
- Insulin Glargine administration & dosage MeSH
- Insulins administration & dosage MeSH
- Cardiovascular Diseases epidemiology MeSH
- Drug Therapy, Combination MeSH
- Anti-Obesity Agents administration & dosage pharmacology adverse effects MeSH
- Humans MeSH
- Liraglutide administration & dosage MeSH
- Multicenter Studies as Topic MeSH
- Randomized Controlled Trials as Topic * MeSH
- Heart Disease Risk Factors MeSH
- Sitagliptin Phosphate administration & dosage MeSH
- Body Weight drug effects MeSH
- Body Weight Changes MeSH
- Check Tag
- Humans MeSH
- MeSH
- Diabetes Mellitus, Type 2 drug therapy complications MeSH
- Adult MeSH
- Sodium-Glucose Transporter 2 Inhibitors * administration & dosage adverse effects MeSH
- Glycated Hemoglobin analysis drug effects MeSH
- Middle Aged MeSH
- Humans MeSH
- Drug-Related Side Effects and Adverse Reactions epidemiology MeSH
- Renal Insufficiency drug therapy complications MeSH
- Aged MeSH
- Sitagliptin Phosphate * administration & dosage adverse effects MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Comment MeSH
- Randomized Controlled Trial MeSH
- Overall MeSH
- MeSH
- Diabetes Mellitus, Type 2 * drug therapy complications MeSH
- Double-Blind Method MeSH
- Sodium-Glucose Transporter 2 Inhibitors administration & dosage MeSH
- Glycated Hemoglobin drug effects MeSH
- Glomerular Filtration Rate MeSH
- Hypoglycemic Agents MeSH
- Humans MeSH
- Renal Insufficiency diagnostic imaging classification MeSH
- Sitagliptin Phosphate administration & dosage MeSH
- Check Tag
- Humans MeSH
- Publication type
- Randomized Controlled Trial MeSH
- MeSH
- Diabetes Mellitus, Type 2 drug therapy MeSH
- Glycated Hemoglobin MeSH
- Dipeptidyl-Peptidase IV Inhibitors therapeutic use MeSH
- Drug Therapy, Combination MeSH
- Humans MeSH
- Metformin administration & dosage MeSH
- Placebos therapeutic use MeSH
- Randomized Controlled Trials as Topic MeSH
- Sitagliptin Phosphate administration & dosage MeSH
- Practice Guidelines as Topic MeSH
- Dose-Response Relationship, Drug MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
- Keywords
- semaglutid,
- MeSH
- Diabetes Mellitus, Type 2 drug therapy MeSH
- Adult MeSH
- Glucagon-Like Peptides * administration & dosage chemistry pharmacokinetics adverse effects MeSH
- Glucagon-Like Peptide 1 analogs & derivatives MeSH
- Glycated Hemoglobin analysis MeSH
- Insulin Glargine administration & dosage MeSH
- Insulin administration & dosage MeSH
- Cardiovascular Diseases epidemiology mortality prevention & control MeSH
- Clinical Studies as Topic MeSH
- Anti-Obesity Agents administration & dosage MeSH
- Humans MeSH
- Drug-Related Side Effects and Adverse Reactions epidemiology MeSH
- Obesity drug therapy MeSH
- Randomized Controlled Trials as Topic MeSH
- Risk MeSH
- Sitagliptin Phosphate administration & dosage adverse effects MeSH
- Body Weight Changes MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Publication type
- Review MeSH
- MeSH
- Diabetes Mellitus, Type 2 drug therapy MeSH
- Insulin Glargine * administration & dosage therapeutic use MeSH
- Drug Therapy, Combination MeSH
- Humans MeSH
- Randomized Controlled Trials as Topic MeSH
- Sitagliptin Phosphate * administration & dosage therapeutic use MeSH
- Check Tag
- Humans MeSH
- Publication type
- Comment MeSH
- Overall MeSH
V kazuistice je prezentován případ 62leté pacientky s dlouhodobě neuspokojivou kompenzací diabetes mellitus 2. typu, která měla velké obavy z aplikace injekční formy léčivých přípravků. Díky novému preparátu Trulicity, jenž je aplikován pouze jednou týdně a je podáván velmi jednoduše použitelným aplikátorem, se její obavy podařilo překonat a došlo ke zlepšení kompenzace diabetu.
The case report of a 62-year-old patient with a long-lasting inadequate control of the type 2 diabetes mellitus is presented. The patient had fear of injection therapy. Thanks to a novel product Trulicity that is administered only once a week she overcame her fear and her glycaemic control improved.
- Keywords
- Trulicity,
- MeSH
- Diabetes Mellitus, Type 2 * drug therapy prevention & control MeSH
- Gliclazide administration & dosage therapeutic use MeSH
- Glycated Hemoglobin isolation & purification drug effects MeSH
- Drug Evaluation MeSH
- Syringes MeSH
- Drug Therapy, Combination * methods trends MeSH
- Blood Glucose isolation & purification drug effects MeSH
- Middle Aged MeSH
- Humans MeSH
- Metformin administration & dosage therapeutic use MeSH
- Glucagon-Like Peptide-1 Receptor * agonists administration & dosage therapeutic use MeSH
- Sitagliptin Phosphate administration & dosage adverse effects therapeutic use MeSH
- Statistics as Topic MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
Léčba bazálním inzulínem (BI) je integrální součástí léčby pacientů s diabetes mellitus (DM) 2. typu. Přestože jsou k dispozici algoritmy titrace inzulínu, u mnoha pacientů s DM 2. typu je glykemická kontrola neuspokojivá. Opoždění v optimalizaci dávky bazálního inzulínu má více důvodů, mezi nejčastěji zmiňované důvody patří přírůstek tělesné hmotnosti a riziko rozvoje hypoglykemie. Požadavkem pro úspěšné vedení léčby je omezení přírůstku hmotnosti, kombinace bazálního inzulínu a inkretinového mimetika (GLP-1 RA) se jeví jako vhodná cesta. Předkládáme zde kazuistiku s úspěšným využitím kombinace bazálního inzulínu glargin 300 U/ml (Gla-300) ve vysoké dávce a jednou týdně aplikovaného GLP-1 RA. Ukazujeme možnost úspěšného využití self-titračního algoritmu v úpravě dávky bazálního inzulínu.
Basal insulin (BI) therapy is integral to the management of people with type 2 diabetes (T2DM). Although insulin titration algorithms are available, in many patients with T2DM the glycaemic control is unsatisfactory. The delay in optimizing basal insulin dose has several reasons. The most frequently mentioned reasons include weight gain and a risk of hypoglycaemia. The requirement for the successful management of treat - ment is to reduce weight gain and the combination of basal insulin and incretin mimetic (GLP-1 RA) seems advantageous for the cause. We present a case report de - scribing a successful use of the combination of basal insulin glargine 300 U/mL (Gla-300) in high dose with a once weekly administered glucagon-like peptide-1 (GLP-1) and we show our favourable experience with the use of self-titration algorithms for basal insulin dose adjustment.
- MeSH
- Algorithms MeSH
- Diabetes Mellitus, Type 2 drug therapy prevention & control MeSH
- Gliclazide administration & dosage adverse effects therapeutic use MeSH
- Hypoglycemia * drug therapy prevention & control MeSH
- Incretins therapeutic use MeSH
- Insulin Detemir administration & dosage therapeutic use MeSH
- Insulin Glargine administration & dosage therapeutic use MeSH
- Insulins * classification therapeutic use MeSH
- Middle Aged MeSH
- Humans MeSH
- Metformin administration & dosage adverse effects therapeutic use MeSH
- Glucagon-Like Peptide-1 Receptor agonists administration & dosage therapeutic use MeSH
- Sitagliptin Phosphate administration & dosage adverse effects therapeutic use MeSH
- Statistics as Topic MeSH
- Body Weight drug effects MeSH
- Titrimetry * methods standards MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
Diabetes mellitus 2. typu je onemocnění s progresivním charakterem a při postupném snižování sekreční kapacity beta buněk pankreatu u řady osob dojde dříve či později k situaci, kdy jen léčba exogenním inzulinem zajistí dobrou kompenzaci diabetu. Cílem studie CompoSIT I bylo zhodnotit vliv pokračování léčby inhibitorem DPP‑4 sitagliptinem při zahájení léčby inzulinem glargin a při následné intenzivní titraci jeho dávky na kompenzaci diabetu a četnost hypoglykemií. Zařazení nemocní s diabetem 2. typu byli randomizováni v poměru 1 : 1 k pokračování léčby sitagliptinem či k jejímu ukončení a k záměně za placebo a současně byla zahajována léčba inzulinem glargin. Primárním sledovaným ukazatelem byla změna koncentrace glykovaného hemoglobinu (HbA1c) ve 30. týdnu studie a četnost dokumentovaných symptomatických hypoglykemií ≤ 3,8 mmol/l. Výsledky ukázaly, že v obou léčebných větvích došlo při titraci inzulinu glargin ke snížení koncentrace HbA1c, které bylo výraznější ve skupině léčené metforminem a ponechaným sitagliptinem oproti skupině léčené metforminem a placebem: –1,88 % vs. –1,42 %. V rámci parametru četnosti dokumentovaných symptomatických hypoglykemií (≤ 3,9 mmol/l) byl na konci studie signifikantní rozdíl mezi hodnocenými větvemi: ve větvi léčené sitagliptinem byla četnost 1,55 epizody/pacient/rok, zatímco ve větvi léčené placebem 2,12 epizody/pacient/rok. Výsledky studie CompoSIT I potvrzují příznivé účinky inhibitoru DPP‑4 sitagliptinu i ve fázi onemocnění, kdy je zahajována léčba bazálním inzulinem. Zlepšení kompenzace diabetu spojené s nízkým rizikem vzniku hypoglykemie či vzestupu tělesné hmotnosti dává sitagliptinu potenciál využití v momentu klinického rozhodování o volbě racionálního konceptu kombinační terapie.
Diabetes mellitus type 2 is a progressive disease and gradual loss of secretional capacity of beta cells leads in need for insulin therapy in certain stage of the disease in order to maintain glucose control in many people. The aim of CompoSIT I study was to compare the effects of continuing vs. discontinuing sitagliptin when initiating and intensively titrating insulin glargine. Methods: Eligible patients with type 2 diabetes were allocated to continuing sitagliptin or discontinuing sitagliptin at randomization, with both groups initiating insulin glargine and titrating to a target fasting glucose of 4.0‑5.6 mmol/l. The primary objectives were to assess the change from baseline in HbA1c and the event rate of documented symptomatic hypoglycemia with BG ≤3.9 mmol/l. Results: Titration of insulin glargine improved HbA1c levels after 30 weeks in both treatment arms, but the change was greater in metformin and continuing sitagliptin group ‑1.88% vs. ‑1.42% in the metformin + placebo group. The event rate of documented symptomatic hypoglycemia with BG ≤3.9 mmol/L over 30 weeks was significantly lower in the sitagliptin group compared with the placebo group (event rate ratio = 0.73, p = 0.039). Results of CompoSIT I confirmed efficacy of DDP‑4 inhibitor sitagliptin in the stage of type 2 diabetes when initiation of basal insulin takes place. Greater reduction in HbA1c without an increase in hypoglycemia or weight gain gives sitagliptin the potential of clinically meaningful use in a moment of decision making about the choice of suitable combination therapy of type 2 diabetes.
- MeSH
- Diabetes Mellitus, Type 2 * drug therapy MeSH
- Double-Blind Method MeSH
- Glycated Hemoglobin standards MeSH
- Insulin Glargine administration & dosage MeSH
- Drug Therapy, Combination MeSH
- Humans MeSH
- Metformin administration & dosage MeSH
- Placebos therapeutic use MeSH
- Sitagliptin Phosphate administration & dosage MeSH
- Check Tag
- Humans MeSH
- Publication type
- Clinical Trial, Phase III MeSH
- Review MeSH
- Randomized Controlled Trial MeSH
- MeSH
- Diabetes Mellitus, Type 2 * diagnosis drug therapy prevention & control MeSH
- Glucagon-Like Peptide 1 * analogs & derivatives administration & dosage therapeutic use MeSH
- Glycated Hemoglobin isolation & purification MeSH
- Insulin Glargine * administration & dosage adverse effects therapeutic use MeSH
- Comorbidity MeSH
- Humans MeSH
- Meta-Analysis as Topic MeSH
- Metformin administration & dosage adverse effects therapeutic use MeSH
- Blood Glucose Self-Monitoring methods MeSH
- Aged MeSH
- Sitagliptin Phosphate administration & dosage adverse effects therapeutic use MeSH
- Statistics as Topic MeSH
- Outcome and Process Assessment, Health Care MeSH
- Check Tag
- Humans MeSH
- Aged MeSH
- Publication type
- Case Reports MeSH
