目的 分析利拉鲁肽联合德谷胰岛素治疗二甲双胍控制不佳的肥胖 2 型糖尿病患者的有效性和安全性.方法 选择 120 例二甲双胍控制不佳的肥胖 2 型糖尿病患者作为研究对象,采用随机数字表法分为对照组和观察组,每组 60 例.对照组患者采用甘精胰岛素治疗,观察组采用利拉鲁肽联合德谷胰岛素治疗.对比两组患者血糖指标[空腹血糖(FPG)、餐后 2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)]、血清C肽[空腹C肽(FCP)和餐后 2 h C肽(2 h PCP)]水平、胰岛素功能[胰岛素敏感指数(IAI)和胰岛素抵抗指数(HOMA-IR)]及不良反应发生率.结果 观察组和对照组患者FPG、2 h PG、HbA1c治疗前对比无明显差异(P>0.05);治疗后,观察组和对照组患者FPG、2 h PG、HbA1c均较治疗前有明显改善,且观察组患者FPG(6.43±1.28)mmol/L、2 h PG(6.75±1.37)mmol/L、HbA1c(6.52±0.60)%均明显低于对照组的(8.27±1.73)mmol/L、(8.86±2.04)mmol/L、(7.42±0.85)%(P<0.05).观察组和对照组患者FCP、2 h PCP治疗前对比无明显差异(P>0.05);治疗后,观察组FCP(1.28±0.22)nmol/L、2 h PCP(5.54±0.42)nmol/L均高于对照组的(1.15±0.17)、(4.78±0.31)nmol/L(P<0.05).观察组和对照组患者IAI和HOMA-IR治疗前对比无明显差异(P>0.05);治疗后,观察组IAI高于对照组、HOMA-IR低于对照组(P<0.05).观察组患者不良反应发生率 6.67%明显低于对照组的 20.00%(P<0.05).结论 针对二甲双胍控制不佳的肥胖 2 型糖尿病采用利拉鲁肽联合德谷胰岛素治疗有明显疗效,对控制血糖水平、改善胰岛素功能有促进作用.
Efficacy and safety of liraglutide combined with insulin degludec in the treatment of obese type 2 diabetes mellitus poorly controlled with metformin therapy
Objective To analyze the efficacy and safety of liraglutide combined with insulin degludec in the treatment of obese patients with type 2 diabetes mellitus poorly controlled with metformin therapy.Methods 120 obese patients with type 2 diabetes mellitus poorly controlled with metformin therapy were studied and divided into a control group and an observation group according to random numerical table,with 60 cases in each group.The control group was treated with insulin glargine,and the observation group was treated with liraglutide and insulin degludec.Patients in both groups were compared in terms of blood glucose indicators[fasting plasma glucose(FPG),2 h postprandial glucose(2 h PG),glycated hemoglobin(HbA1c)],serum C-peptide[fasting C-peptide(FCP)and 2 h postprandial C-peptide(2 h PCP)]level,insulin function[insulin active index(IAI)and Homeostasis Model Assessment of Insulin Resistance(HOMA-IR)]and incidence of adverse reactions.Results There was no significant difference in the comparison of FPG,2 h PG,HbA1c between the observation group and the control group before treatment(P>0.05).After treatment,FPG,2 h PG,HbA1c of patients in the observation group and the control group were significantly improved compared with those before treatment;the observation group had FPG of(6.43±1.28)mmol/L,2 h PG of(6.75±1.37)mmol/L,HbA1c of(6.52±0.60)%,which were significantly lower than(8.27±1.73)mmol/L,(8.86±2.04)mmol/L,and(7.42±0.85)%in the control group(P<0.05).There was no significant difference in the comparison of FCP and 2 h PCP between the observation group and the control group before treatment(P>0.05).After treatment,the observation group had FCP of(1.28±0.22)nmol/L and 2 h PCP of(5.54±0.42)nmol/L,which were higher than(1.15±0.17)and(4.78±0.31)nmol/L of the control group(P<0.05).There was no significant difference in the comparison of IAI and HOMA-IR between the observation group and the control group before treatment(P>0.05).After treatment,the observation group had higher IAI and lower HOMA-IR than those in the control group(P<0.05).The incidence rate of adverse reactions in the observation group was 6.67%,which was significantly lower than 20.00%in the control group(P<0.05).Conclusion For obese patients with type 2 diabetes mellitus poorly controlled with metformin therapy,liraglutide combined with insulin degludec has a significant efficacy on controlling blood glucose level and improving insulin function.
LiraglutideInsulin degludecObese type 2 diabetes mellitusPoorly controlled with metformin
万方数据
维普
