首页|达格列净联合司美格鲁肽治疗肥胖型2型糖尿病患者临床效果观察

达格列净联合司美格鲁肽治疗肥胖型2型糖尿病患者临床效果观察

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目的:探讨达格列净联合司美格鲁肽在肥胖型 2 型糖尿病(T2DM)患者中的治疗效果.方法:选取 2021年2月—2022年11月本院收治的70例肥胖型T2DM患者,按随机数字表法分两组,各35例.两组患者均口服二甲双胍0.5 g/次,3次/d;指导合理饮食、不良反应识别及处理等;对照组于早餐前腹部皮下注射司美格鲁肽,初始剂量0.25 mg/次,1 次/周;4 周后剂量翻倍至 0.5 mg/次,1 次/周,持续用药 12 周;在上述基础上,观察组口服达格列净片 10 mg/次,1次/d,持续用药 12 周.比较两组治疗前后的糖脂代谢指标、体重控制情况、胰岛功能及不良反应发生情况.结果:治疗前两组糖脂代指标、体重、体质量指数(BMI)和胰岛功能比较,差异无统计学意义(P>0.05);治疗后两组空腹血糖(FPG)、餐后 2h血糖(2 hPG)、糖化血红蛋白(HbAlc)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、甘油三酯(TG)、全身总脂肪质量、体脂率、体重、BMI和胰岛素抵抗指数(HOMA-IR)水平均低于治疗前,且观察组低于对照组;两组高密度脂蛋白胆固醇(HDL-C)和胰岛β细胞功能指数(HOMA-β)水平高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05).两组不良反应发生率比较,差异无统计学意义(P>0.05).结论:达格列净联合司美格鲁肽能够改善肥胖型T2DM患者血糖、血脂,降低体重水平,提高胰岛功能,且不良反应少.
Clinical effect of dapagliflozin combined with smeglutide in the treatment of obese patients with type 2 diabetes mellitus
Objective:To investigate the therapeutic effects of dapagliflozin combined with smeglutide in obese patients with type 2 diabetes mellitus(T2DM).Methods:A total of 70 obese T2DM patients admitted to our hospital from February 2021 to November 2022 were selected and divided into two groups,with 35 patients in each group according to the random number table method.Patients in both groups were given metformin(0.5 g/time,3 times/day)and guidance on reasonable diet and identification and management of adverse reactions.The control group received subcutaneous injection of smeglutide into the abdomen before breakfast,with an initial dose of 0.25 mg/time,once per week.After 4 weeks,the dosage doubled to 0.5 mg/time,once per week,and continued for 12 weeks.Based on the above,the observation group received oral dapagliflozin tablets 10 mg/time,once a day,for a continuous period of 12 weeks.Glucose and lipid metabolism indices,weight control,islet function,and adverse reactions were compared between the two groups before and after treatment.Results:Before treatment,there were no significant differences in the glycolipid metabolism index,body weight,body mass index(BMI),and islet function between the two groups(P>0.05).After treatment,the levels of fasting blood glucose(FPG),2-hour postprandial blood glucose(2 hPG),glycated hemoglobin(HbAlc),low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),triglycerides(TG),total body fat mass,body fat rate,body weight,BMI,and insulin resistance index(HOMA-IR)in the two groups were lower than those before treatment,and the observation group was lower than that of the control group.The levels of high-density lipoprotein cholesterol(HDL-C)and islet β-cell function index(HOMA-β)in the two groups were higher than before treatment,and the observation group was higher than the control group,with a statistically significant difference(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:The combination of dapagliflozin and smeglutide can improve blood glucose and blood lipid levels,reduce weight,enhance pancreatic islet function,and have fewer adverse reactions in obese T2DM patients.

obese type 2 diabetes mellitusdapagliflozinsmeglutideglycolipid metabolismadverse reactions

喻美玲、胡燕红

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高安市人民医院,江西 330800

肥胖型2型糖尿病 达格列净 司美格鲁肽 糖脂代谢 不良反应

宜春市科技局项目

2023ZDJH2931

2024

天津药学
天津市医药集团有限公司 天津市药学会

天津药学

影响因子:0.794
ISSN:1006-5687
年,卷(期):2024.36(2)
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