地特胰岛素联合利拉鲁肽对肥胖2型糖尿病患者的临床疗效

目的探讨地特胰岛素联合利拉鲁肽对治疗肥胖2型糖尿病患者的临床疗效及安全性。方法选取使用基础胰岛素联合餐时胰岛素血糖控制不达标的肥胖2型糖尿病患者42例，将其治疗方案调整为地特胰岛素联合利拉鲁肽，总疗程12周，治疗期间根据血糖监测水平调整地特胰岛素及利拉鲁肽用量。分别于治疗前及治疗12周后测定患者体质量、体质量指数（BMI）、腰围（cm）、空腹c肽（ng／m1）、空腹血糖（FBG）、糖化血红蛋白（HbA1c）胰岛素日用量（IU），并观察不良反应。结果治疗后体质量、BMI、腰围、FBG、HbA1c、胰岛素日用量较治疗前均有降低，而空腹C肽较前升高，与治疗前比较差异均有统计学意义（P〈0．05）。结论对血糖控制不佳的肥胖2型糖尿病，利拉鲁肽联合地特胰岛素治疗可有效降低血糖，控制体质量及改善胰岛功能，是治疗肥胖2型糖尿病患者有效且安全的降糖药物。

Objective To investigate the efficacy and safety of liraglutide combined with insulin detemir in the treatment of obese type 2 diabetes mellitus. Methods Forty-two paitents with obese type 2 diabetes treated with basal insulin with meal insulin but failed to control their blood glucose were selected, liraglutide combined with insulin detemir were used to replace the initial protocol, lasting for 12 weeks.During the treatment, adjustment of insulin detemir and liraglutide dosage were done according to the levels of blood glucose.Before and after treatment, the following items were measured： weight, body mass index （ BMI ） , waist, fasting plasma glucose （ FPG ） , fasting C-P, hemoglobin AlC （ HbAlc ） , insulin dosage. Results After the treatment, the levels of FBG, HbAlc, BMI、 insulin dosage, waist, weight declined （P〈0.05） , and, fasting C-P tend to elevate （ P〈0.05 ） .Conclusion For the obese type 2 diabetes mellitus with the uncontrollable blood glucose liraglutide combined with insulin detemir can be used to effectively decrease the blood glucose eontroll body weight and improve islet function.