上個月醫療群請心臟科醫師介紹 glyxambi. 講者提到. glyxambi 是零差評的藥物
115-06-23健保藥品給付規定
糖尿病藥物
2. 使用條件：(105/5/1、114/6/1)
2. 使用條件：(105/5/1、114/6/1)
(1) 原則上第二型糖尿病治療應優先使用 metformin，或考慮早期開始使用胰島素。除有過敏、禁忌症、不能耐受或仍無法理想控制血糖的情形下，可使用其他類口服降血糖藥物。
(2) TZD 製劑、DPP-4抑制劑、SGLT-2抑制劑、以及含該3類成分之複方製劑，限用於已接受過最大耐受劑量的 metformin 仍無法理想控制血糖之第二型糖尿病病人，且 SGLT-2抑制劑與 DPP-4抑制劑及其複方製劑宜二種擇一種使用。
(3) 第二型糖尿病病人倘於使用三種口服降血糖藥物治療仍無法理想控制血糖者，宜考慮給予胰島素治療。
(4) 特約醫療院所應加強衛教第二型糖尿病病人，鼓勵健康生活型態的飲食和運動，如控制肥胖、限制熱量攝取等措施。
2026-01-23剛剛藥商來訪. 提供這篇 Glyxambi 研究報告給我參考
健保規定的邏輯. DPP4i 或 SGLT2Ri 不能同時使用
如果病患吃了六個月 DPP4i 血糖仍控制不佳
想要並用 SGLT2Ri 只能選擇複方 Glyxambi
健保規定. 需使用最大耐受劑量 metformin 且並用 linagliptin(TRAJENTA 5mg 糖漸平) 或 Empagliflozin（Jardiance恩排糖）六個月以上
HbA1c > 7.5% 才可開立.
Glyxambi (糖順平25/5毫克)= trajenta 5mg + Jardiance 25mg
Linagliptin=TRAJENTA 5mg 糖漸平 DPP4i
Empagliflozin=Jardiance 25mg/恩排糖 SGLT2i
Combination of empagliflozin and linagliptin improves blood pressure and vascular function in type 2 diabetes
Abstract
Aims: Preserved vascular function represents a key prognostic factor in type 2 diabetes mellitus (T2DM), but data on vascular parameters in this patient cohort are scarce. Patients with T2DM often need more than one drug to achieve optimal glucose control. The aim of this study was to analyse the efficacy of two combination therapies on vascular function in subjects with T2DM.
Methods and results: This prospective, randomized study included 97 subjects with T2DM. Subjects were randomized to either the combination therapy empagliflozin (E) 10 mg with linagliptin (L) 5 mg once daily or metformin (M) 850 or 1000 mg twice daily with insulin glargine (I) once daily. At baseline and after 12 weeks, subjects had peripheral office and 24-h ambulatory blood pressure (BP) measurement and underwent vascular assessment by pulse wave analysis under office and ambulatory conditions. Office, 24-h ambulatory and central BP as well as pulse pressure (PP) decreased after 12 weeks of treatment with E + L, whereas no change was observed in M + I. There were greater decreases in 24-h ambulatory peripheral systolic (between-group difference: -5.2 ± 1.5 mmHg, P = 0.004), diastolic BP (-1.9 ± 1.0 mmHg, P = 0.036), and PP (-3.3 ± 1.0 mmHg, P = 0.007) in E + L than M + I. Central office systolic BP (-5.56 ± 1.9 mmHg, P = 0.009), forward pressure height of the pulse wave (-2.0 ± 0.9 mmHg, P = 0.028), 24-h ambulatory central systolic (-3.6 ± 1.4 mmHg, P = 0.045), diastolic BP (-1.95 ± 1.1 mmHg, P = 0.041), and 24-h pulse wave velocity (-0.14 ± 0.05m/s, P = 0.043) were reduced to a greater extent with E + L.
Conclusion: Beyond the effects on glycaemic control, the combination therapy of E + L significantly improved central BP and vascular function compared with the classic combination of M + I.
Clinicaltrials.gov: NCT02752113.
Abstract
Aims: Preserved vascular function represents a key prognostic factor in type 2 diabetes mellitus (T2DM), but data on vascular parameters in this patient cohort are scarce. Patients with T2DM often need more than one drug to achieve optimal glucose control. The aim of this study was to analyse the efficacy of two combination therapies on vascular function in subjects with T2DM.
Methods and results: This prospective, randomized study included 97 subjects with T2DM. Subjects were randomized to either the combination therapy empagliflozin (E) 10 mg with linagliptin (L) 5 mg once daily or metformin (M) 850 or 1000 mg twice daily with insulin glargine (I) once daily. At baseline and after 12 weeks, subjects had peripheral office and 24-h ambulatory blood pressure (BP) measurement and underwent vascular assessment by pulse wave analysis under office and ambulatory conditions. Office, 24-h ambulatory and central BP as well as pulse pressure (PP) decreased after 12 weeks of treatment with E + L, whereas no change was observed in M + I. There were greater decreases in 24-h ambulatory peripheral systolic (between-group difference: -5.2 ± 1.5 mmHg, P = 0.004), diastolic BP (-1.9 ± 1.0 mmHg, P = 0.036), and PP (-3.3 ± 1.0 mmHg, P = 0.007) in E + L than M + I. Central office systolic BP (-5.56 ± 1.9 mmHg, P = 0.009), forward pressure height of the pulse wave (-2.0 ± 0.9 mmHg, P = 0.028), 24-h ambulatory central systolic (-3.6 ± 1.4 mmHg, P = 0.045), diastolic BP (-1.95 ± 1.1 mmHg, P = 0.041), and 24-h pulse wave velocity (-0.14 ± 0.05m/s, P = 0.043) were reduced to a greater extent with E + L.
Conclusion: Beyond the effects on glycaemic control, the combination therapy of E + L significantly improved central BP and vascular function compared with the classic combination of M + I.
Clinicaltrials.gov: NCT02752113.
