Objective

To assess the effect of exenatide (a GLP-1 receptor agonist), dipeptidyl peptidase-IV (DPP-IV) inhibitors, and sodium-glucose co-transporter 2 (SGLT-2) inhibitors on measures of peripheral nerve excitability in patients with type 2 diabetes.

Methods

Patients receiving either exenatide (n = 32), a DPP-IV inhibitor (n = 31), or a SGLT-2 inhibitor (n = 27) underwent motor nerve excitability assessments. Groups were similar in age, sex, HbA_1c, diabetes duration, lipids, and neuropathy severity. An additional 10 subjects were assessed prospectively over 3 months while oral anti-hyperglycaemic therapy was kept constant. A cohort of healthy controls (n = 32) were recruited for comparison.

Results

Patients receiving a DPP-IV or SGLT-2 inhibitor demonstrated abnormalities in peak threshold reduction, S2 accommodation, superexcitability, and subexcitability. In contrast, patients treated with exenatide were observed to have normal nerve excitability. In the prospective arm, exenatide therapy was associated with an improvement in nerve function as patients demonstrated corrections in S2 accommodation, superexcitability, and subexcitability at follow-up. These changes were independent of the reductions in HbA_1c following exenatide treatment.

Conclusions

Exenatide was associated with an improvement in measures of nerve excitability in patients with type 2 diabetes.

Significance

Exenatide may improve peripheral nerve function in type 2 diabetes.

中文翻译：

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艾塞那肽对2型糖尿病周围神经兴奋性的影响

客观的

评估艾塞那肽（一种 GLP-1 受体激动剂）、二肽基肽酶-IV (DPP-IV) 抑制剂和钠-葡萄糖协同转运蛋白 2 (SGLT-2) 抑制剂对以下类型患者周围神经兴奋性测量的影响2 糖尿病。

方法

接受艾塞那肽（n = 32）、DPP-IV 抑制剂（n = 31）或 SGLT-2 抑制剂（n = 27）的患者接受了运动神经兴奋性评估。各组在年龄、性别、HbA _1c、糖尿病病程、血脂和神经病变严重程度方面相似。在保持口服抗高血糖治疗不变的情况下，另外 10 名受试者在 3 个月内进行了前瞻性评估。招募了一组健康对照（n = 32）进行比较。

结果

接受 DPP-IV 或 SGLT-2 抑制剂的患者在峰值阈值降低、S2 调节、超兴奋性和亚兴奋性方面表现出异常。相反，观察到接受艾塞那肽治疗的患者具有正常的神经兴奋性。在前瞻性组中，艾塞那肽治疗与神经功能的改善相关，因为患者在随访时表现出 S2 调节、超兴奋性和亚兴奋性的纠正。这些变化与艾塞那肽治疗后HbA _1c的降低无关。

结论

艾塞那肽与 2 型糖尿病患者神经兴奋性测量的改善有关。

意义

艾塞那肽可改善 2 型糖尿病患者的周围神经功能。