Efficacy of the combination of semaglutide,insulin degludec,and metformin in the treatment of type 2 diabetes mellitus and poor glycemic control accompanied by overweight or obesity
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NETL
NSTL
万方数据
维普
目的 分析司美格鲁肽、德谷胰岛素联合二甲双胍治疗血糖控制不佳伴超重或肥胖2型糖尿病患者的疗效.方法 选取巴彦淖尔市医院2022年4月至2023年3月收治的血糖控制不佳伴超重或肥胖2型糖尿病患者160例进行病例对照研究,根据治疗方案不同分为对照组、观察组各80例.对照组采用德谷胰岛素联合二甲双胍治疗,观察组采用司美格鲁肽、德谷胰岛素联合二甲双胍治疗,两组治疗12周.观察两组空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)、餐后2 h血糖目标范围内时间(TIR)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMAIR)、身体质量指数(BMI)、内脏脂肪面积(VFA)的变化和不良反应发生情况.结果 观察组总有效率为100.0％(80/80),高于对照组的 97.5％(78/80)(x2=11.03,P＜0.05).治疗后,观察组 2 h PG、HbAlc、FINS、HOMAIR、BMI、VFA 分别为(7.35±0.17)mmol/L、(6.08±0.24)％、(10.30±2.58)μU/mL、(2.69±0.66)、(24.40±0.68)kg/m2、(80.20±8.94)cm2,均低于对照组的(7.92±0.24)mmol/L、(6.34±0.27)％、(13.71± 3.13)μU/mL、(3.57±0.83)、(26.77±3.49)kg/m2、(116.12±34.09)cm2(t=-0.73、-3.74、-4.20、-4.15、-3.35、-5.10,均P＜0.05);观察组 TIR为(72.68±4.09)％,高于对照组的(50.16±10.00)％(t=-10.42,P＜0.05).观察组不良反应发生率为3.8％(3/80),高于对照组的2.5％(2/80),但差异无统计学意义(P＞0.05).结论 司美格鲁肽、德谷胰岛素联合二甲双胍治疗血糖控制不佳伴超重或肥胖2型糖尿病患者临床效果理想,可有效控制空腹及餐后血糖水平,明显降低身体质量指数和内脏脂肪水平,改善胰岛素抵抗且不明显增加不良反应.
Objective To investigate the efficacy of the combination of semaglutide,insulin degludec,and metformin in the treatment of type 2 diabetes mellitus and poor glycemic control accompanied by overweight or obesity.Methods A total of 160 patients with type 2 diabetes mellitus and poor glycemic control accompanied by overweight or obesity were included in this case-control study after receiving treatment at Bayannur Hospital from April 2022 to March 2023.These patients were divided into a control group and an observation group based on different treatment regimens,with 80 patients in each group.The control group was treated with degludec insulin combined with metformin,while the observation group was treated with semaglutide,degludec insulin,and metformin.The treatment lasted for 12 weeks in both groups.The changes in fasting plasma glucose,2-hour postprandial blood glucose(2 h PG),glycosylated hemoglobin,time in range for 2 h PG,fasting insulin,Homeostatic Model Assessment for Insulin Resistance index,body mass index,and visceral fat area and adverse reactions were monitored.Results The overall response rate in the observation group was 100％(80/80),which was significantly higher than 97.5％(78/80)in the control group(x2=11.03,P＜0.05).After treatment,the levels of 2 h PG,glycosylated hemoglobin,fasting insulin,Homeostatic Model Assessment for Insulin Resistance.index,body mass index,visceral fat area in the observation group were(7.35±0.17)mmol/L,(6.08 ±0.24)％,(10.30±2.58)μU/mL,(2.69±0.66),(24.40±0.68)kg/m2,(80.20±8.94)cm2,respectively,which were significantly lower than(7.92±0.24)mmol/L,(6.34±0.27)％,(13.71±3.13)μU/mL,(3.57±0.83),(26.77±3.49)kg/m2,(116.12±34.09)cm2 respectively in the control group(t=-0.73,-3.74,-4.20,-4.15,-3.35,-5.10,all P＜0.05).The time in range for 2 h PG in the observation group was(72.68±4.09)％,which was significantly higher than(50.16±10.00)％in the control group(t=-10.42,P＜0.05).The incidence of adverse reactions in the observation group was 3.8％(3/80),which was slightly,but not significantly,higher than 2.5％(2/80)in the control group(P＞0.05).Conclusion The combination of semaglutide,degludec insulin,and metformin demonstrates an ideal clinical effect in the treatment of type 2 diabetes mellitus and poor glycemic control accompanied by overweight or obesity.This combined approach can effectively regulate fasting and postprandial blood glucose levels,markedly decrease the body mass index and visceral fat levels,and improve insulin resistance while not significantly increasing the incidence of adverse reactions.
NETL
NSTL
万方数据
维普
