Journal of Diabetes Science and Technology,
Год журнала:
2024,
Номер
unknown
Опубликована: Дек. 31, 2024
Type
1
diabetes
(T1D)
necessitates
lifelong
insulin
therapy
due
to
the
autoimmune
destruction
of
insulin-producing
pancreatic
beta
cells.
Despite
advancements
in
technology
and
formulations,
maintaining
optimal
glycemic
outcomes
remains
challenging
these
individuals.
Obesity,
accompanied
by
resistance,
is
common
not
only
type
2
(T2D)
but
also
many
individuals
with
T1D.
Glucagon-like
peptide-1
receptor
agonists
(GLP-1
RAs),
approved
for
T2D
obesity,
are
now
being
explored
off-label
use
This
review
examines
their
efficacy,
safety,
potential
benefits
T1D
management.
We
reviewed
articles
published
up
May
2024
from
databases
like
PubMed
Scopus,
mainly
focusing
on
human
studies
GLP-1
RAs
T1D,
as
well
cardiorenal
metabolic
obesity.
Semaglutide
other
showed
significant
improvements
outcomes,
hemoglobin
A1c
levels,
reduced
doses,
notable
weight
loss.
Studies
obesity
lipid
profile
offered
protection.
Common
side
effects
include
gastrointestinal
issues,
while
some
reported
hypoglycemia,
hyperglycemia,
ketosis,
others
did
not.
challenges,
offer
therapeutic
benefits,
making
them
a
promising
adjunct
improving
clinical
Importance
Bariatric
surgery,
once
the
criterion
standard
in
obesity
treatment,
has
a
small
but
concerning
association
with
increased
suicidality.
Glucagon-like
peptide
1
receptor
agonists
(GLP-1
RAs),
originally
developed
to
treat
diabetes,
now
provide
substantial
efficacy
treatment
of
obesity.
However,
concerns
risk
suicidality
these
medicines
have
been
raised.
Objective
To
evaluate
and
self-harm
randomized,
placebo-controlled
trials
GLP-1
RAs
adults
diabetes
or
Data
Sources
MEDLINE,
Embase,
ClinicalTrials.gov,
Cochrane
databases
were
systematically
searched
from
inception
August
29,
2023.
Study
Selection
Reports
randomized
clinical
(RCTs)
lasting
6
more
months
comparing
placebo
for
published
peer-reviewed
journals
identified.
Two
independent
reviewers
screened
all
search-identified
studies
inclusion.
Records
outcomes
queried
primary
papers,
ClinicalTrials.gov
entries,
corresponding
authors.
Extraction
Synthesis
researchers
abstracted
data
assessed
quality
validity
using
PRISMA
guidelines.
pooled
random-effects
models.
Main
Outcomes
Measures
Pooled
incidence
completed
attempted
suicide,
occurrences
suicidal
ideation,
self-harm.
Results
A
total
27
144
RCTs
meeting
inclusion
criteria
recorded
suicide
and/or
self-harm-related
events
included
32
357
individuals
receiving
046
treated
placebo,
over
74
740
68
095
person-years
follow-up,
respectively.
Event
was
very
low
RA
(0.044
per
100
person-years)
(0.040
groups,
no
statistically
significant
difference
(rate
ratio
[RR],
0.76;
95%
CI,
0.48-1.21;
P
=
.24).
Subgroup
analyses
did
not
suggest
differences
based
on
status
used.
Five
considered
at
bias
due
loss
than
5%
participants
follow-up.
Otherwise,
found
be
heterogeneous
nor
high
bias.
Conclusions
Relevance
There
is
unlikely
an
increase
suicide-related
adverse
among
within
context
RCTs.
While
findings
may
further
ease
about
effects,
continued
monitoring
warranted
identify
particular
patients
who
as
extended
use
expands.
Medico e Bambino,
Год журнала:
2024,
Номер
43(9), С. 553 - 554
Опубликована: Ноя. 7, 2024
Sipario:
un
dolce
caso
di
fegato
grande
Indimenticabile!
Osteomielite
in
pillole
Terapia
genica
1:
virus
che
curano,
uccidono
2:
taglia
e
cuci
Come
vanno
a
finire
Analoghi
del
GLP-1
salute
mentale
Good
Morning
AI!
Acta Psychiatrica Scandinavica,
Год журнала:
2024,
Номер
unknown
Опубликована: Ноя. 8, 2024
Patients
with
mental
disorders
have
a
significantly
reduced
lifespan,1
overweight/obesity
and
cardiometabolic-related
death
being
the
biggest
contributors.
Both
underlying
illness
treatments,
especially
antipsychotics,
contribute
to
this
increased
cardiometabolic
risk,
creating
dilemma
between
efficacy
desired
safety.
As
point
in
fact,
clozapine
is
second-generation
antipsychotic
proven
otherwise
treatment-resistant
patients
diagnosis
of
schizophrenia.
However,
also
linked
substantial
increase
body
weight
carries
high
risk
for
metabolic
disturbances,2
making
clinicians,
patients,
caretakers
reluctant
against
its
use.
Additionally,
sedentary
lifestyle
unhealthy
food
intake
become
public
health
issue
populations
Western
world
general.
they
are
an
even
bigger
problem
among
people
severe
disorders,
such
as
schizophrenia
bipolar
disorder.
Also,
use
antipsychotics
has
expanded
beyond
disorder,
used
frequently
on-label
unipolar
depression,
but
off-label
impulsive
behaviors,
insomnia,
anxiety
other
conditions.3
Over
last
decade,
more
focus
been
paid
monitoring
uncovering
potential
dysmetabolism
by
blood
sample
analysis
treated
which
important
steps
right
direction.
clear,
well-established
strategies
effective
treatment
and,
especially,
those
receiving
or
mentally
ill,
remain
underdeveloped
or,
at
least,
underutilized.4
The
most
strategy
preventing
antipsychotic-induced
gain
using
these
medications
only
when
needed
starting
lowest
potential.4
When
adverse
effects
occur,
secondary
preventive
efforts
include
switching
less
dysmetabolism,
although
loss
may
be
limited.5
Moreover,
case
clozapine,
partial
complete
antipsychotic,
if
it
impose
fewer
dysmetabolic
problems
weight,
not
applicable
strategy.6
Nonpharmacological
interventions
changes
overweight
well-known
strategies7
but-as
background
population-are
difficult
implement
broadly.
Traditionally,
adjunctive
pharmacological
antipsychotic-associated
included
topiramate
metformin.
weight-lowering
compounds
somewhat
modest—typically
range
3–4
kg
over
12–24
weeks.8,
9
This
leaves
great
need
additional
augmentation
that
mitigate,
reverse,
prevent
antipsychotic-related
gain,
devoid
any
effects.10
Glucagon-like
peptide-1
(GLP-1)
incretin
hormone
synthesized
L-cells
intestine
released
response
intake,
causing
delayed
stomach
emptying.
GLP-1
receptor
stimulation
increases
insulin
secretion
reduces
glucagon
secretion,
thereby
stabilizing
glucose
homeostasis.11
nucleus
solitary
tract
brain
stem
hypothalamus
areas
involved
satiety,
where
believed
decrease
appetite
influence
weight.12
agonists
(GLP-1
RAs)
clinic
type
2
diabetes
mellitus
since
2007
2020,
newer
RAs,
example,
dulaglutide,
semaglutide,
tirzepatide,
shown
potent
effects.13
To
date,
few
studies
investigated
RAs
specifically
antipsychotic-treated
data
from
incorporated
recent
systematic
review
meta-analysis
Bak
et
al.
showing
beneficial
on
overweight.14
What
risks
psychiatric
diagnosis?
common
events
were
nausea,
vomiting,
diarrhea
generally
tolerable14
similar
trials.
due
preclinical
evidence
interact
homeostasis,
reducing
dopamine
caused
drugs
abuse,15
concern
raised
whether
could
induce
anhedonia,
suicidal
ideation,
worsen
symptoms
preexisting
issues.
Recent
cohort
studies16
post
hoc
clinical
trials17
do
indicate
risk.
general
population
trials,
known
illnesses
excluded.
Therefore,
trials
including
essential
ensure
safe
populations.
In
reviewed
al.,
psychopathology
was
assessed
different
rating
scales.
transformed
into
one
single
scale:
7-point
Clinical
Global
Impression
Severity
scale
(CGI),
no
significant
global
observed.14
approach
clearly
lacks
precision,
number
participants
across
four
very
small,
mean
identify
individual
who
suicidal.
further
fully
assess
illness.
Why
commonly
psychiatry?
One
argument
abnormalities
needed.
Fortunately,
several
investigating
RA
finished
recruitment
(ClinicalTrials.gov
ID
NCT05333003;
ClinicalTrials.gov
NCT05193578).
Hence,
specific
patient
expected
available
soon.
hope
pharmaceutical
companies
would
initiate
larger
RCTs
populations,
schizophrenia,
depression
prescribed
particularly
vulnerable
burden.
already
approved
diabetes,
obesity
factors,
independent
medication
treatment,
indication
subgroup
provide
sufficient
incentive,
justify
widespread
prevention
initiating
relevant
Another
costs
GLP-1RAs
present,
carry
barriers
equity
issues
non-psychiatric
some
patents
expire
soon,
so
cheaper
RAS
will
likely
cost
preventable
far
higher.
meantime,
governments
willing
cover
illness,
treatment.
AFJ
received
two
unrestricted
research
grants
Novo
Nordisk
A/S
member
advisory
board
study
(no
honorary).
CUC
consultant
and/or
advisor
honoraria
from:
AbbVie,
Alkermes,
Allergan,
Angelini,
Aristo,
Boehringer-Ingelheim,
Bristol-Meyers
Squibb,
Cardio
Diagnostics,
Cerevel,
CNX
Therapeutics,
Compass
Pathways,
Darnitsa,
Delpor,
Denovo,
Eli
Lilly,
Gedeon
Richter,
Hikma,
Holmusk,
IntraCellular
Therapies,
Jamjoom
Pharma,
Janssen/J&J,
Karuna,
LB
Lundbeck,
MedInCell,
MedLink,
Merck,
Mindpax,
Mitsubishi
Tanabe
Maplight,
Mylan,
Neumora
Neurocrine,
Neurelis,
Newron,
Noven,
Nordisk,
Otsuka,
PPD
Biotech,
Recordati,
Relmada,
Reviva,
Rovi,
Saladax,
Sanofi,
Seqirus,
Servier,
Sumitomo
Pharma
America,
Sunovion,
Sun
Supernus,
Tabuk,
Takeda,
Teva,
Terran,
Tolmar,
Vertex,
Viatris,
Xenon
Pharmaceuticals.
He
provided
expert
testimony
Janssen,
Otsuka.
served
Data
Safety
Monitoring
Board
Rovi.
grant
support
Takeda.
royalties
UpToDate
stock
option
holder
Kuleon
Biosciences,
Medlink,
Quantic,
Terran.
peer
history
article
https://www.webofscience.com/api/gateway/wos/peer-review/10.1111/acps.13769.
Journal of Diabetes Science and Technology,
Год журнала:
2024,
Номер
unknown
Опубликована: Дек. 31, 2024
Type
1
diabetes
(T1D)
necessitates
lifelong
insulin
therapy
due
to
the
autoimmune
destruction
of
insulin-producing
pancreatic
beta
cells.
Despite
advancements
in
technology
and
formulations,
maintaining
optimal
glycemic
outcomes
remains
challenging
these
individuals.
Obesity,
accompanied
by
resistance,
is
common
not
only
type
2
(T2D)
but
also
many
individuals
with
T1D.
Glucagon-like
peptide-1
receptor
agonists
(GLP-1
RAs),
approved
for
T2D
obesity,
are
now
being
explored
off-label
use
This
review
examines
their
efficacy,
safety,
potential
benefits
T1D
management.
We
reviewed
articles
published
up
May
2024
from
databases
like
PubMed
Scopus,
mainly
focusing
on
human
studies
GLP-1
RAs
T1D,
as
well
cardiorenal
metabolic
obesity.
Semaglutide
other
showed
significant
improvements
outcomes,
hemoglobin
A1c
levels,
reduced
doses,
notable
weight
loss.
Studies
obesity
lipid
profile
offered
protection.
Common
side
effects
include
gastrointestinal
issues,
while
some
reported
hypoglycemia,
hyperglycemia,
ketosis,
others
did
not.
challenges,
offer
therapeutic
benefits,
making
them
a
promising
adjunct
improving
clinical
