Time：2023-04-01 12:17:45 source：psychiatricethics.com author：Public activities Read：622次

GLP-1 receptor agonists can be used for poor blood sugar control with metformin, which can also protect the cardiovascular system

A friend who was suffering from diabetes left a message to Hua Zi. He was still unable to control his blood sugar after taking metformin and acarbose. Someone suggested that he should use a drug called "peptide" for treatment, saying that it was also good for the heart. What kind of medicine? Hua Zi said that hypoglycemic drugs with "peptides" in their names should refer to GLP-1 receptor agonists. Liraglutide, dulaglutide, semaglutide, and exena are commonly used now. Drugs such as peptide microspheres and loxenatide can not only lower blood sugar, but also protect the cardiovascular system.

I. What is a GLP-1 receptor agonist

The human gut can secrete a multifunctional peptide hormone, which can Activation of the glucagon-like peptide-1 (GLP-1) receptor can promote insulin secretion in a glucose-dependent manner, and can also delay gastric emptying, reduce food intake, and lead to weight loss. However, the peptide hormones naturally secreted by the human body will be rapidly decomposed by dipeptidyl peptidase 4 (DPP-4) after entering the blood and lose their effect. Therefore, people have developed GLP-1 receptor agonists that are similar in structure to human natural peptide hormones, and can also activate GLP-1 receptors to reduce blood sugar. GLP-1 receptor agonists are glucose-dependent, the risk of hypoglycemia is small, and while reducing blood sugar, it also has a protective effect on nerve cells and cardiomyocytes.

2. Commonly used GLP-1 receptor agonists

There are a variety of GLP-1 receptor agonists currently on the market, including Laglutide and semaglutide are the most commonly used. The oral dosage form of semaglutide is being declared in China, and it will take some time before it is launched. At present, all three have injection forms, liraglutide needs to be injected once a day; dulaglutide and semaglutide are injected once a week. Liraglutide and semaglutide are approved in the United States for weight loss treatment in obese individuals, while dulaglutide is only used for the treatment of type 2 diabetes. However, all three drugs can only be used for the treatment of type 2 diabetes in my country, not for weight loss. Semaglutide is developed on the basis of liraglutide, so semaglutide can be regarded as a "weekly preparation" of liraglutide. Dosing once a week is more convenient and can improve patients' medication compliance. Therefore, the most important varieties of GLP-1 receptor agonists are dulaglutide and semaglutide.

Third, the difference between dulaglutide and semaglutide

The half-life of dulaglutide is 4.7 days, and the half-life of semaglutide is 7 days, the longer the half-life, the smaller the change in blood drug concentration during the treatment process, so the drug concentration of semaglutide is more stable. The usual dose of dulaglutide is 1.5 mg, and the usual dose of semaglutide is 0.5 mg, both of which can reduce glycated hemoglobin (HbA1c) by 1.5% from baseline, but semaglutide at 1.0 mg , HbA1c can be reduced by 1.8%. Semaglutide is more effective than dulaglutide in controlling blood sugar, weight loss, and blood pressure. In terms of cardiovascular protection, dulaglutide has a broad cardiovascular protective effect on patients with type 2 diabetes, while semaglutide has a protective effect on patients with type 2 diabetes complicated by coronary atherosclerotic cardiovascular disease. Therefore, compared with the two, semaglutide is more suitable for patients with type 2 diabetes who need weight loss, and dulaglutide is more suitable for patients with type 2 diabetes who need cardiovascular protection. To sum up, on the basis of controlling diet and strengthening exercise, using metformin and other hypoglycemic drugs, those who still have poor blood sugar control can choose GLP-1 receptor agonists for treatment. Have better protection. The medicine should be used under the guidance of a doctor. If you have any doubts about the medicine, please consult your doctor or pharmacist. I am Huazi, a pharmacist. Welcome to follow me and share more health knowledge.

(责任编辑：Relax)

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