利拉鲁肽治疗血糖控制不佳超重2型糖尿病的疗效

Effects of liraglutide on overweight type 2 diabetes mellitus patients with poor glycemic control

目的观察利拉鲁肽治疗血糖控制不佳超重2型糖尿病(T2DM)患者的临床效果。方法 40例口服降糖药物联合胰岛素治疗后血糖控制不佳的超重T2DM患者,在原治疗方案不变的基础上加用利拉鲁肽注射液,连用12周。观察治疗前、治疗后4周和12周空腹血糖(FPG)、餐后2h血糖(2h PG)、空腹胰岛素(FINS)、空腹C肽、糖化血红蛋白(Hb A1c)、体重指数(BMI)、血脂的变化情况。结果治疗后FPG、2h PG、空腹C肽、Hb A1c、BMI较治疗前均明显下降(P<0.05),随着时间的增加,上述各指标均逐渐降低(P<0.05);治疗前后患者总胆固醇、高密度胆固醇、低密度胆固醇、甘油三酯、脂联素、瘦素水平比较,差异无统计学意义(P>0.05)。40例患者平均Hb A1c、体重由治疗前的8.6%、74.4 kg,下降至治疗12周后的7.6%、71.1 kg,分别减少了1.0%、3.3 kg。Hb A1c下降幅度与患者治疗前Hb A1c水平呈正相关(P<0.05),与患者既往使用胰岛素呈负相关(P<0.05),与其他指标无明显相关性(P>0.05)。治疗期间无低血糖、无胰腺炎及不良免疫反应等发生。结论利拉鲁肽对血糖控制不佳超重2型糖尿病(T2DM)患者的治疗效果好,可明显降低体重,改善血糖。

Objective To observe the effects of liraglutide on overweight type 2 diabetes mellitus （T2DM） patients with poor glycemic control. Methods Forty overweight T2DM patients with poor glycemic control received insulin combined with oral antidiabetic drugs previously. Hraglutide injection was added based on primary treatment regimen,with 12 weeks as a course of treatment. The changes in fasting blood glucose （ FPG）, 2 -hour postprandial blood glucose （ 2hPG ）, fasting insulin （FINS）, fasting C -peptide, glycosylated hemoglobin （HbA1c）,body mass index （BMI） and blood lipid were observed before treatment, 4 weeks and 12 weeks after treatment, respectively. Results The levels of FPG,2hPG, fasting C-peptide, HbA1c and BMI significantly decreased after treatment （ P 〈 0.05 ）, and the levels of the above indexes gradually reduced over time （ P 〈 0. 05 ）. The levels of total cholesterol, high density hpoprotein cholesterol, low density lipoprotein cholesterol ,triglycerides ,adiponectin and leptin before and after treatment showed no statistically significant differenee（P 〉0. 05）. The average levels of HbA1c and body weight,from 8.6% and 74. 4 kg before treatment,dropped to 7. 6% and 71.1 kg 12 weeks after treatment, decreased by 1.0% and 3.3kg,respectively. The decrease of HbA1 c positively correlated with the level of HbA1 e before treatment（P 〈0. 05） and negatively correlated with the previous insulin dosage （ P 〈 0.05 ）, but it didn＇t significantly correlate with the other indexes （ P 〉 0.05 ）. No serious adverse reactions, such as hypoglycemia, pancreatitis and adverse immune reactions and so on, occurred during the treatment. Conclusion Liraglutide achieves better effects on overweight T2DM patients with poor glycemic control, which can significantly reduce the patient＇ body weight and improve blood glucose.