THE METFORMIN-EXENATIDE-INSULIN (MEXELIN) TRIAL

二甲双胍-艾塞那肽-胰岛素 (MEXELIN) 试验

• 批准号: 7951994
• 负责人: ROBERT E RATNER
• 金额: $ 5.09万
• 依托单位: GEORGETOWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-04-01 至 2010-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7951994
• 关键词: Agonist; Amino Acids; Animals; Body Weight decreased; Clinical Research; Computer Retrieval of Information on Scientific Projects Database; Eating; Funding; Gastric Emptying; Glucagon; Glucose; Glycosylated hemoglobin A; Grant; Human; Hyperglycemia; Hypoglycemic Agents; Institution; Insulin; Life Style; Measures; Metformin; Oral; Pamphlets; Pancreas; Pharmaceutical Preparations; Research; Research Personnel; Resources; Source; United States National Institutes of Health; Weight Gain; diabetic; exenatide; feeding; glucagon-like peptide 1; incretin hormone; insulin secretion; polypeptide; receptor; response

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Type 2 diabetics can have inadequate control of hyperglycemia despite the use of insulin plus several oral hypoglycemic drugs and lifestyle changes. Exenatide is a 39 amino acid polypeptide that is a receptor agonist for the endogenous incretin hormone called glucagon-like peptide-1 (GLP-1). Incretins increase pancreatic insulin secretion in response to elevations in glucose (hyperglycemia). Animal and human studies suggest several mechanisms of action: (i) enhanced insulin secretion in response to feeding and glucose elevation; (ii) suppression of inappropriately elevated glucagon secretion; (iii) decreased rate of gastric emptying and so slowed the rate of glucose delivery; (iv) reduced food intake, and, unlike insulin (v) weight reduction. The drug was efficacious in over 30 human studies lasting up to 132 weeks (studies summarized on page 20 of drug brochure). Decreased HbA1c was used as the primary efficacy measure. Exenatide decreased HbA1c in an equivalent fashion to insulin, but caused weight reduction unlike the weight gain associated with insulin.

该子项目是利用该技术的众多研究子项目之一 资源由 NIH/NCRR 资助的中心拨款提供。子项目及 研究者 (PI) 可能已从 NIH 的另一个来源获得主要资金， 因此可以在其他 CRISP 条目中表示。列出的机构是 对于中心来说，它不一定是研究者的机构。 尽管使用胰岛素加多种口服降糖药物并改变生活方式，2 型糖尿病患者仍无法充分控制高血糖。艾塞那肽是一种 39 个氨基酸的多肽，是称为胰高血糖素样肽-1 (GLP-1) 的内源性肠促胰岛素激素的受体激动剂。肠促胰素可响应葡萄糖升高（高血糖）而增加胰腺胰岛素分泌。动物和人类研究表明了几种作用机制：（i）响应进食和血糖升高而增强胰岛素分泌； (ii)抑制不适当地升高的胰高血糖素分泌； (iii) 胃排空率降低，从而减慢葡萄糖输送率； (iv) 减少食物摄入量，并且与胰岛素不同的是 (v) 减轻体重。该药物在超过 30 项持续长达 132 周的人体研究中显示有效（药物手册第 20 页上总结了研究）。降低 HbA1c 被用作主要疗效指标。艾塞那肽以与胰岛素相同的方式降低 HbA1c，但与胰岛素相关的体重增加不同，它会导致体重减轻。