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    Home > Active Ingredient News > Endocrine System > Unique "heart" to open a new era of hypoglycemic

    Unique "heart" to open a new era of hypoglycemic

    • Last Update: 2022-03-07
    • Source: Internet
    • Author: User
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    *For medical professionals to read and reference GLP-1RA Weekly Formulation, Multiple Helps in Diabetes Management
    .

    The latest epidemiological survey shows that the burden of type 2 diabetes (T2DM) in China is heavy, and the blood glucose compliance rate of diabetic patients in China is less than half [1].
    ]
    .

    From this, it is not difficult to see that Chinese T2DM patients urgently need to strengthen blood sugar control, but also face challenges such as high prevalence of cardiovascular disease and irregular treatment
    .

    Emerging drug glucagon-like peptide-1 receptor agonist (GLP-1RA) - semaglutide injection, as a drug with potent hypoglycemic, cardiovascular benefits and a half-life of up to 7 days[ 3], which can help improve the current situation of T2DM patients in China
    .

    Based on this, the "medical community" invited Professor Zhu Zhiming, director of the Department of Hypertension and Endocrinology of Chongqing Daping Hospital, Professor Zhou Bo of the Department of Endocrinology of the First Affiliated Hospital of Chongqing Medical University, and Professor Wei Ping, director of the Department of Endocrinology of Chongqing Southwest Hospital, to discuss with us in-depth this new drop.
    sugar medication
    .

    The multiple functions of GLP-1RA weekly preparations Professor Zhu Zhiming said that the most important role of GLP-1RA weekly preparations in the treatment of T2DM is to effectively lower blood sugar
    .

    The SUSTAIN China study [4] showed that among Chinese patients, the glycated hemoglobin (HbA1c) decreased by as much as 1.
    8% in patients treated with semaglutide, and the patients who achieved the blood sugar control target of HbA1c < 7% were as high as 86.
    1%.
    One more effective hypoglycemic option
    .

    Semaglutide also has a long-acting effect.
    Its half-life in the body is as long as 7 days after subcutaneous injection [3] (Figure 1).
    It can be administered once a week.
    compliance
    .

    In addition, semaglutide retains up to 94% of the amino acid sequence homology of GLP-1, with good safety [5,6]
    .

    In addition, not only to reduce blood sugar, the SUSTAIN series of Phase 3 clinical trials have also successfully demonstrated that weekly subcutaneous injection of semaglutide can improve body weight, blood pressure, blood lipids and other cardiovascular and metabolic indicators [7], which is very important for diabetes.
    Cardiovascular protection and comprehensive disease management of patients are of great help
    .

    Figure 1 The plasma concentration curve of semaglutide in steady state, Professor Zhu Zhiming mentioned: "The characteristics of diabetic patients are not only increased blood sugar, but most of the patients are accompanied by obesity, hypertension, dyslipidemia and other comorbidities.
    While reducing blood sugar, peptides can also reduce weight, lower blood pressure and improve blood lipids, helping patients to benefit comprehensively
    .

    The Cardiovascular Outcomes Trial (CVOT) SUSTAIN 6 study [8] of the Cardiovascular Outcomes Trial (CVOT) of Semaglutide for Diabetes Management showed that in T2DM patients with high cardiovascular risk, patients receiving semaglutide were significantly better than placebo Compared with the drug group, the risk of major adverse cardiovascular events (MACE) was significantly reduced by 26% (Figure 2), which shows that the cardiovascular benefit of semaglutide is very clear
    .

    In 2021, semaglutide injection will be officially approved for marketing in China.
    It is used for adult patients with T2DM who are still poorly controlled by metformin and/or sulfonylureas on the basis of diet control and exercise, and to reduce the risk of comorbidities.
    The risk of major cardiovascular adverse events in T2DM adult patients with cardiovascular disease has become the only GLP-1RA weekly preparation with cardiovascular indications in China
    .

    Figure 2 The semaglutide group significantly reduced the risk of MACE by 26%.
    "For T2DM patients with cardiovascular disease or high risk, GLP-1RA weekly preparation can be used on the basis of life>
    .

    "Professor Zhou Bo said
    .

    It is suitable for many types of people to help blood sugar reach the standard.
    Professor Wei Ping said that the source of the current low blood sugar standard rate is mainly related to three aspects-patient, medical, and medicine
    .

    First, many patients have an urgent need for health knowledge reserves .
    It needs to be strengthened, and the lack of cooperation with diabetes management has led to the generally low blood sugar compliance rate
    .

    Secondly, some doctors' diabetes management concepts need to be updated, which also affects the blood sugar compliance rate to a certain extent
    .

    In addition, in terms of medication, the choice of hypoglycemic Effective therapeutic drugs are very important
    .

    With the development of new drugs, new hypoglycemic drugs that have appeared in recent years have not only improved their hypoglycemic efficacy, but also made great progress in the management of diabetic complications
    .

    For example, this year The semaglutide marketed in China can not only make the blood sugar compliance rate of Chinese patients reach as high as 86.
    1%, but also has cardiovascular benefits[3,8]
    .

    Professor Wei Ping then emphasized that in order to improve the treatment compliance of diabetic patients For people with more comorbidities, it is recommended to choose a treatment plan with less frequent injections, fewer types of drugs, and a simpler treatment plan
    .

    Semaglutide, as a weekly preparation of GLP-1RA, takes into account both strong hypoglycemia and cardiovascular benefits.

    The
    "China Guidelines for the Prevention and Treatment of Type 2 Diabetes (2020 Edition)" pointed out [9] that T2DM patients with atherosclerotic cardiovascular disease (ASCVD) or high risk of cardiovascular risk, regardless of whether their HbA1c reached the standard or not, as long as there are no contraindications Both GLP-1RA or sodium-glucose cotransporter-2 inhibitor (SGLT-2i) with evidence of ASCVD benefit should be added to metformin
    .

    Even without ASCVD or high-risk factors, T2DM patients can be further managed with GLP-1RA after life>
    .

    From the guideline recommendation to the clinical implementation, there is a long way to go.
    Although GLP-1RA with cardiovascular benefits has been recommended by the guideline, its use status in China is not optimistic
    .

    The CAPTURE Chinese subgroup study showed [10] that 33.
    9% of T2DM patients had cardiovascular disease (34.
    8% globally), of which about 94.
    9% had ASCVD, and only 1.
    5% of these patients had applied GLP-1RA
    .

    It can be seen that how to apply the guideline recommendation to the clinic is a serious challenge that we are facing now
    .

    Summary: At present, the current situation of diabetes treatment in China is relatively severe, and there are many unmet treatment needs
    .

    With the optimization of the diabetes management concept, new drugs that are more in line with the comprehensive management concept emerge as the times require
    .

    Semaglutide injection, which has long-acting, strong and multi-acting effects, will be officially launched in China in 2021, opening up a new situation for diabetes management
    .

    References: [1] Wang L, et al.
    JAMA.
    2017; 317(24): 2515-23.
    [2] National Health Commission Capacity Building and Continuing Education Center.
    Chinese Journal of Internal Medicine.
    2021;60(5): 421-437.
    [3]Kapitza C,et al.
    Diabetologia.
    2017;60:1390-9.
    [4]Ji L,et al.
    Diabetes Obes Metab.
    2021;23(2):404-414.
    [5] Kapitza C et al.
    J Clin Pharmacol.
    2015;55:497–504.
    [6]Lund A et al.
    Eur J Intern Med.
    2014;25:407–14.
    [7]Zinman B,et al.
    Lancet Diabetes Endocrinol .
    2019;7(5):356-367.
    [8]Marso SP,et al.
    N Engl J Med.
    2017;376(9):891-2.
    [9]Chinese Medical Association Diabetes Society.
    Chinese Journal of Diabetes .
    2021;13(4):315-409.
    [10]Guillermo Dieuzeide.
    2021 ADA presentation.
    -End- "This article is for the purpose of providing scientific information to healthcare professionals only and does not represent the platform's position" Contribution/Reprint/Business For cooperation, please contact: pengsanmei@yxj.
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