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Su Y, Zhang S, Wu Z, Liu W, Chen J, Deng F, Chen F, Zhu D, Hou K. Pharmacoeconomic analysis (CER) of Dulaglutide and Liraglutide in the treatment of patients with type 2 diabetes. Front Endocrinol (Lausanne) 2023; 14:1054946. [PMID: 36755915 PMCID: PMC9899911 DOI: 10.3389/fendo.2023.1054946] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 01/09/2023] [Indexed: 01/24/2023] Open
Abstract
AIM To evaluate the treatment effect Fand pharmacoeconomic value of Dugaglutide in women with type 2 diabetes. METHODS Women (n=96) with type 2 diabetes recruited from June 2019 to December 2021 were randomized into two equal groups. The control group was treated with Liraglutide, and the observation group was treated with Dulaglutide, both for 24 weeks. The blood glucose levels, biochemical index, insulin resistance index (HOMA-IR), cost-effect ratio (CER), and drug safety were determined and compared between the two groups. RESULTS Blood glucose levels, the biochemical index, and HOMA-IR were lower in both groups after the treatment (P < 0.05), and there was no statistical difference in the blood glucose levels, biochemical index and HOMA-IR between the two groups (P > 0.05). The CER levels did not differ statistically between the two groups (P > 0.05). Both the cost and the incidence of drug side effects during solution injection were lower in the observation group than in the control group after 24 weeks of treatment (P < 0.05). CONCLUSION Both Dulaglutide and Liraglutide can reduce blood glucose levels, improve biochemical index, and HOMA-IR levels in women with type 2 diabetes. Dulaglutide is more cost-effective and safe. CLINICAL TRIAL REGISTRATION https://www.chictr.org.cn/index.aspx, identifier ChiCTR1900026514.
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Affiliation(s)
- Yu Su
- Center of Teaching Evaluation and Faculty Development, Anhui University of Chinese medicine, Hefei, Anhui, China
| | - Shuo Zhang
- Medical College of Shantou University, Shantou, China
- Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Department of Endocrine and Metabolic Diseases, Longhu People’s Hospital, Shantou, China
| | - Zezhen Wu
- Medical College of Shantou University, Shantou, China
- Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Department of Endocrine and Metabolic Diseases, Longhu People’s Hospital, Shantou, China
| | - Weiting Liu
- School of nursing, Anhui University of Chinese medicine, Hefei, Anhui, China
| | - Jingxian Chen
- Medical College of Shantou University, Shantou, China
- Department of Endocrine and Metabolic Diseases, Longhu People’s Hospital, Shantou, China
| | - Feiying Deng
- Medical College of Shantou University, Shantou, China
- Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Department of Endocrine and Metabolic Diseases, Longhu People’s Hospital, Shantou, China
| | - Fengwu Chen
- Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Department of Endocrine and Metabolic Diseases, Longhu People’s Hospital, Shantou, China
| | - Dan Zhu
- Department of Endocrine and Metabolic Diseases, Longhu People’s Hospital, Shantou, China
| | - Kaijian Hou
- School of Public Health, Shantou University, Shantou, China
- *Correspondence: Kaijian Hou,
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da Silva EM, Yariwake VY, Alves RW, de Araujo DR, Andrade-Oliveira V. Crosstalk between incretin hormones, Th17 and Treg cells in inflammatory diseases. Peptides 2022; 155:170834. [PMID: 35753504 DOI: 10.1016/j.peptides.2022.170834] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/20/2022] [Accepted: 06/20/2022] [Indexed: 02/07/2023]
Abstract
Intestinal epithelial cells constantly crosstalk with the gut microbiota and immune cells of the gut lamina propria. Enteroendocrine cells, secrete hormones, such as incretin hormones, which participate in host physiological events, such as stimulating insulin secretion, satiety, and glucose homeostasis. Interestingly, evidence suggests that the incretin pathway may influence immune cell activation. Consequently, drugs targeting the incretin hormone signaling pathway may ameliorate inflammatory diseases such as inflammatory bowel diseases, cancer, and autoimmune diseases. In this review, we discuss how these hormones may modulate two subsets of CD4 + T cells, the regulatory T cells (Treg)/Th17 axis important for gut homeostasis: thus, preventing the development and progression of inflammatory diseases. We also summarize the main experimental and clinical findings using drugs targeting the glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide (GLP-1) signaling pathways and their great impact on conditions in which the Treg/Th17 axis is disturbed such as inflammatory diseases and cancer. Understanding the role of incretin stimulation in immune cell activation and function, might contribute to new therapeutic designs for the treatment of inflammatory diseases, autoimmunity, and tumors.
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Affiliation(s)
| | - Victor Yuji Yariwake
- Department of Immunology - Institute of Biomedical Sciences, University of São Paulo (USP), Brazil
| | - Renan Willian Alves
- Center for Natural and Human Sciences, Federal University of ABC (UFABC), Brazil
| | | | - Vinicius Andrade-Oliveira
- Paulista School of Medicine, Federal University of São Paulo (UNIFESP), Brazil; Department of Immunology - Institute of Biomedical Sciences, University of São Paulo (USP), Brazil; Center for Natural and Human Sciences, Federal University of ABC (UFABC), Brazil.
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Brill AL, Wisinski JA, Cadena MT, Thompson MF, Fenske RJ, Brar HK, Schaid MD, Pasker RL, Kimple ME. Synergy Between Gαz Deficiency and GLP-1 Analog Treatment in Preserving Functional β-Cell Mass in Experimental Diabetes. Mol Endocrinol 2016; 30:543-56. [PMID: 27049466 DOI: 10.1210/me.2015-1164] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
A defining characteristic of type 1 diabetes mellitus (T1DM) pathophysiology is pancreatic β-cell death and dysfunction, resulting in insufficient insulin secretion to properly control blood glucose levels. Treatments that promote β-cell replication and survival, thus reversing the loss of β-cell mass, while also preserving β-cell function, could lead to a real cure for T1DM. The α-subunit of the heterotrimeric Gz protein, Gαz, is a tonic negative regulator of adenylate cyclase and downstream cAMP production. cAMP is one of a few identified signaling molecules that can simultaneously have a positive impact on pancreatic islet β-cell proliferation, survival, and function. The purpose of our study was to determine whether mice lacking Gαz might be protected, at least partially, from β-cell loss and dysfunction after streptozotocin treatment. We also aimed to determine whether Gαz might act in concert with an activator of the cAMP-stimulatory glucagon-like peptide 1 receptor, exendin-4 (Ex4). Without Ex4 treatment, Gαz-null mice still developed hyperglycemia, albeit delayed. The same finding held true for wild-type mice treated with Ex4. With Ex4 treatment, Gαz-null mice were protected from developing severe hyperglycemia. Immunohistological studies performed on pancreas sections and in vitro apoptosis, cytotoxicity, and survival assays demonstrated a clear effect of Gαz signaling on pancreatic β-cell replication and death; β-cell function was also improved in Gαz-null islets. These data support our hypothesis that a combination of therapies targeting both stimulatory and inhibitory pathways will be more effective than either alone at protecting, preserving, and possibly regenerating β-cell mass and function in T1DM.
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Affiliation(s)
- Allison L Brill
- Department of Medicine (A.L.B., J.A.W., M.T.C., M.F.T., H.K.B., R.L.P., M.E.K.), Division of Endocrinology, Diabetes, and Metabolism; Department of Cell and Regenerative Biology (M.E.K.); and Interdisciplinary Graduate Program in Nutritional Sciences (R.J.F., M.D.S., M.E.K.), University of Wisconsin-Madison, Madison; and Research Service (A.L.B., J.A.W., M.T.C., M.F.T., R.J.F., H.K.B., M.D.S., M.E.K.), William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin 53705
| | - Jaclyn A Wisinski
- Department of Medicine (A.L.B., J.A.W., M.T.C., M.F.T., H.K.B., R.L.P., M.E.K.), Division of Endocrinology, Diabetes, and Metabolism; Department of Cell and Regenerative Biology (M.E.K.); and Interdisciplinary Graduate Program in Nutritional Sciences (R.J.F., M.D.S., M.E.K.), University of Wisconsin-Madison, Madison; and Research Service (A.L.B., J.A.W., M.T.C., M.F.T., R.J.F., H.K.B., M.D.S., M.E.K.), William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin 53705
| | - Mark T Cadena
- Department of Medicine (A.L.B., J.A.W., M.T.C., M.F.T., H.K.B., R.L.P., M.E.K.), Division of Endocrinology, Diabetes, and Metabolism; Department of Cell and Regenerative Biology (M.E.K.); and Interdisciplinary Graduate Program in Nutritional Sciences (R.J.F., M.D.S., M.E.K.), University of Wisconsin-Madison, Madison; and Research Service (A.L.B., J.A.W., M.T.C., M.F.T., R.J.F., H.K.B., M.D.S., M.E.K.), William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin 53705
| | - Mary F Thompson
- Department of Medicine (A.L.B., J.A.W., M.T.C., M.F.T., H.K.B., R.L.P., M.E.K.), Division of Endocrinology, Diabetes, and Metabolism; Department of Cell and Regenerative Biology (M.E.K.); and Interdisciplinary Graduate Program in Nutritional Sciences (R.J.F., M.D.S., M.E.K.), University of Wisconsin-Madison, Madison; and Research Service (A.L.B., J.A.W., M.T.C., M.F.T., R.J.F., H.K.B., M.D.S., M.E.K.), William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin 53705
| | - Rachel J Fenske
- Department of Medicine (A.L.B., J.A.W., M.T.C., M.F.T., H.K.B., R.L.P., M.E.K.), Division of Endocrinology, Diabetes, and Metabolism; Department of Cell and Regenerative Biology (M.E.K.); and Interdisciplinary Graduate Program in Nutritional Sciences (R.J.F., M.D.S., M.E.K.), University of Wisconsin-Madison, Madison; and Research Service (A.L.B., J.A.W., M.T.C., M.F.T., R.J.F., H.K.B., M.D.S., M.E.K.), William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin 53705
| | - Harpreet K Brar
- Department of Medicine (A.L.B., J.A.W., M.T.C., M.F.T., H.K.B., R.L.P., M.E.K.), Division of Endocrinology, Diabetes, and Metabolism; Department of Cell and Regenerative Biology (M.E.K.); and Interdisciplinary Graduate Program in Nutritional Sciences (R.J.F., M.D.S., M.E.K.), University of Wisconsin-Madison, Madison; and Research Service (A.L.B., J.A.W., M.T.C., M.F.T., R.J.F., H.K.B., M.D.S., M.E.K.), William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin 53705
| | - Michael D Schaid
- Department of Medicine (A.L.B., J.A.W., M.T.C., M.F.T., H.K.B., R.L.P., M.E.K.), Division of Endocrinology, Diabetes, and Metabolism; Department of Cell and Regenerative Biology (M.E.K.); and Interdisciplinary Graduate Program in Nutritional Sciences (R.J.F., M.D.S., M.E.K.), University of Wisconsin-Madison, Madison; and Research Service (A.L.B., J.A.W., M.T.C., M.F.T., R.J.F., H.K.B., M.D.S., M.E.K.), William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin 53705
| | - Renee L Pasker
- Department of Medicine (A.L.B., J.A.W., M.T.C., M.F.T., H.K.B., R.L.P., M.E.K.), Division of Endocrinology, Diabetes, and Metabolism; Department of Cell and Regenerative Biology (M.E.K.); and Interdisciplinary Graduate Program in Nutritional Sciences (R.J.F., M.D.S., M.E.K.), University of Wisconsin-Madison, Madison; and Research Service (A.L.B., J.A.W., M.T.C., M.F.T., R.J.F., H.K.B., M.D.S., M.E.K.), William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin 53705
| | - Michelle E Kimple
- Department of Medicine (A.L.B., J.A.W., M.T.C., M.F.T., H.K.B., R.L.P., M.E.K.), Division of Endocrinology, Diabetes, and Metabolism; Department of Cell and Regenerative Biology (M.E.K.); and Interdisciplinary Graduate Program in Nutritional Sciences (R.J.F., M.D.S., M.E.K.), University of Wisconsin-Madison, Madison; and Research Service (A.L.B., J.A.W., M.T.C., M.F.T., R.J.F., H.K.B., M.D.S., M.E.K.), William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin 53705
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