Jekeseni wa Tirzepatide wa Matenda a Shuga ndi Kuonda

Tirzepatide ndi mtundu wapawiri wodalira shuga wa insulinotropic polypeptide (GIP) ndi glucagon-ngati peptide-1 (GLP-1) receptor agonist yopangidwa. Njira yake yapawiri imafuna kupititsa patsogolo katulutsidwe ka insulini, kupondereza kutulutsidwa kwa glucagon, kuchedwetsa kutulutsa m'mimba, komanso kukonza kukhuta, kupereka njira zochiritsira zamtundu wa 2 shuga mellitus (T2DM) ndi kunenepa kwambiri.

Zotsatira zazikulu kuchokera ku Maphunziro a Zachipatala

1. Glycemic Control

Pafupi ndi zambiriKUPOSAMayesero azachipatala a gawo 3, tirzepatide adawonetsakuwongolera bwino kwa glycemicpoyerekeza ndi antidiabetic agents omwe alipo, kuphatikiza semaglutide ndi insulin degludec.

• Kuchepetsa kwa HbA1c: mpaka−2.4%kuyambira pachiyambi pambuyo pa masabata 40-52.

• Chiwerengero chapamwamba cha omwe atenga nawo mbali apindulaHbA1c <6.5%, kukumana kapena kupitilira zolinga za ADA.

• Kusintha kwakukulu pakusala kudya kwa plasma glucose ndi postprandial glucose kunawonedwa.

2. Kuchepetsa Kulemera

Tirzepatide imapangidwa nthawi zonsezachipatala kutanthawuza ndi mlingo amadalira kuwondamwa anthu odwala matenda a shuga komanso omwe alibe matenda a shuga.

• Odwala a T2DM: pafupifupi kuchepa kwa thupi kunali koyambira7-12 kg.

• Odwala omwe alibe matenda a shuga (mayesero a SURMOUNT-1):

  • Mlingo wa 10 mg ndi 15 mg umayambitsa15-22% amatanthauza kuchepa kwa thupi, kufananiza kapena kupitirira malire a opaleshoni ya bariatric.

• Ambiri omwe adatenga nawo mbali adakwanitsa5-10%kuchepetsa kulemera.

3. Kusintha kwa Cardiometabolic

Chithandizo cha Tirzepatide chinathandiziranso magawo ambiri a metabolic:

• Kuchepetsamu triglycerides, LDL-C, ndi cholesterol chonse.

• Kuwonjezekamu HDL-C.

• Zofunikakuchepa kwa kuthamanga kwa magazi kwa systolic ndi diastolic.

• Kupititsa patsogolo kukhudzidwa kwa insulin komanso magwiridwe antchito a β-cell.

4. Chitetezo ndi Kulekerera

Mbiri yachitetezo inali yogwirizana ndi mankhwala ena opangidwa ndi incretin:

• Zotsatira zoyipa kwambiri: nseru, kusanza, kutsekula m'mimba (kutsekula m'mimba, kutsekula m'mimba).

• Kuchepa kwa hypoglycemia, makamaka mukamagwiritsa ntchito insulin kapena sulfonylurea.

• Palibe zodetsa nkhawa zazikulu zachitetezo zomwe zimawonedwa muzotsatira zamtima.

5. Kuzindikira Kwamakanika

Tirzepatide ndi wapaderaawiri receptor agonismimakulitsa njira zonse za GIP ndi GLP-1:

• GIP activationimathandizira katulutsidwe ka insulin yodalira glucose ndipo imatha kusintha kagayidwe ka minofu ya adipose.

• GLP-1 kuyambitsakumachepetsa chilakolako cha kudya ndikuchedwetsa kutulutsa m'mimba.

• Zawosynergistic zotsatirakumabweretsa kuwongolera kwa glucose ndikuchepetsa kulemera poyerekeza ndi njira imodzi.

Mapeto

Tirzepatide imayimira akusintha kwa metabolic therapy, kuperekaKuchita bwino kwambiri pakuwongolera glycemic komanso kuchepetsa thupikwa anthu omwe ali ndi matenda amtundu wa 2 komanso kunenepa kwambiri.
Njira yake yapawiri ya incretin imapereka njira yophatikizira yothana ndi zomwe zimayambitsa kusagwira bwino ntchito kwa metabolic - hyperglycemia, kukana insulini, komanso kulemera kwambiri kwa thupi.
Potengera mphamvu zake zolimba komanso mbiri yachitetezo chokhazikika, tirzepatide ikhoza kutanthauziranso njira yochizira matenda a shuga ndi kasamalidwe ka kunenepa kwambiri m'zaka khumi zikubwerazi.

Maumboni

• Frias JP et al.,New England Journal of Medicine, 2021.

• Jastreboff AM et al.,New England Journal of Medicine, 2022 (SURMOUNT-1).

• Ludvik B et al.,Lancet, 2021.

• Eli Lilly Clinical Data, SURPASS Mayesero 1-5.