糖尿病藥物 Glyxamal 糖順平 Combination of empagliflozin and linagliptin improves blood pressure and vascular function in type 2 diabetes

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. 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.

野外與登山醫學-高海拔疾病 AMS. HACE. HAPE 發作時間

2026-01-23 00:44 AM

筆記-2025 CDC yellow book
CDC-High-Altitude Travel and Altitude Illness(CDC網站)
AMS症狀通常在抵達高海拔地區或攀登至更高海拔後 2-12 小時內出現
在相同海拔沒有繼續上升. AMS 通常會在 12-48 小時內消退。
Symptom onset is usually 2–12 hours after initial arrival at a high altitude or after ascent to a higher elevation and often during or after the first night. Preverbal children with AMS can develop loss of appetite, irritability, and pallor. AMS generally resolves within 12–48 hours if travelers do not ascend farther.
Symptoms starting after 3 days of arrival at high altitude and without further ascent should not be attributed to AMS

筆記 2023 High Altitude Pulmonary Edema(Archived)-Jacob D. Jensen
HAPE typically occurs 2 to 5 days after arrival at altitude.
2013NEJM
AMS 通常在上升到海拔2500公尺以上, 6-12小時之後發生。

(from uptodate)High-altitude pulmonary edema This topic last updated: Nov 19, 2025.

HAPE 高海拔肺水腫發生率 0.01-15% (在同樣海拔上升速率, 比 HACE 高). 通常在到達高海拔之後 2-4 天發作.
 Initial symptoms typically appear two to four days after arrival at a new altitude.