Comparative Efficacy and Cardiovascular Benefits of Different GLP-1 Receptor Agonists(Liraglutide,Dulaglutide,and Semaglutide)Com-bined with Metformin in the Treatment of Type 2 Diabetes
The study aims to evaluate and compare the therapeutic effectiveness and potential cardiovascular advantages of three dis-tinct GLP-1 receptor agonists(liraglutide,dulaglutide,and semaglutide)when used in combination with metformin for the manage-ment of type 2 diabetes mellitus(T2DM),and also aims to assess the impact of these treatment regimens on glycemic control,body composition,and cardiovascular outcomes in T2DM patients.24-week randomized controlled trial enrolled 80 T2DM patients,equally divided into four groups:liraglutide+metformin,dulaglutide+metformin,semaglutide+metformin,and metformin alone.GLP-1 receptor agonists were administered per standard protocols,with metformin doses optimized across groups.Assessments at baseline and 24 weeks included fasting plasma glucose(FPG),2-hour postprandial glucose(2hPG),glycated hemoglobin(HbA1c),body weight,waist circumference,and homeostasis model assessment of insulin resistance(HOMA-IR).Cardiovascular events were moni-tored throughout the study.Blood samples were collected after overnight fasting and 2 hours post-standardized meal.HbA1c was measured using high-performance liquid chromatography.Cardiovascular events were documented based on clinical examinations and verified through medical records.Compared with the metformin group,FPG,2hPG,HbA1c,and HOMA-IR levels significantly decreased in the three GLP-1 receptor agonist groups(P＜0.05),with similar hypoglycemic effects.The decreases in body weight and waist circumference were more significant in the semaglutide group and dulaglutide group(P＜0.05).The incidence of cardio-vascular events in all three treatment groups was lower than that in the metformin group,with the semaglutide group showing the most prominent cardiovascular benefits,including significant reductions in major events such as cardiovascular death,myocardial infarc-tion,and stroke.The main adverse reactions were mild gastrointestinal reactions,and no severe hypoglycemia occurred.Liraglutide,dulaglutide,and semaglutide combined with metformin have similar efficacy in the treatment of T2DM,effectively controlling blood glucose,improving insulin resistance,and potentially reducing the risk of cardiovascular events.Among them,semaglutide has the most comprehensive cardiovascular benefits.All three drugs have good safety profiles.
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