GLP-1受体激动剂联合门冬胰岛素30对2型糖尿病患者控糖效果及体重的影响

Effect of GLP-1 Receptor Agonists combined with Insulin Aspart 30 on the Glucose Control and Weight of Patients with Type 2 Diabetes Mellitus

目的:探讨胰高血糖素样肽-1(GLP-1)受体激动剂联合门冬胰岛素30对2型糖尿病患者控糖效果及体重的影响。方法:选取116例2型糖尿病患者为研究对象,随机数字表法分成研究组(A组,n=58)和对照组(B组,n=58)两组。B组予以门冬胰岛素30治疗方案,A组则采用门冬胰岛素30联合利拉鲁肽治疗方案,均持续治疗24周后观察疗效。比对两组患者治疗前后控糖指标、脂质生化指标及体重指数(BMI)等变化情况,记录其甲级血糖控制率、血糖总控制率及低血糖发生率差异。结果:1治疗6个月后,两组患者除HDL-C水平较治疗前对比无统计学意义(P>0.05)外,FBG、2 h PG、Hb A1c等控糖指标,TG、TC、LDL-C等脂质生化指标及BMI水平均较治疗前显著降低,其中A组降幅大于B组,差异具有统计学意义(P<0.05);2A组甲级控制率及血糖总控制率分别为70.7%和100.0%,均显著高于B组的37.9%和93.1%(P<0.05);3两组患者治疗期间均无严重不良反应及严重低血糖事件发生,其中A组轻微低血糖发生率为6.9%(4/58),显著低于B组的24.1%(14/58),差异具有统计学意义(P<0.05)。结论:将门冬胰岛素30联合GLP-1受体激动剂方案应用于2型糖尿病患者的临床治疗中,疗效确切,血糖控制效果良好,能有效改善其血脂水平、抑制体重发展,于患者预后提升有利。

Objective： To investigate the effect of glucagon like peptide-1（GLP-1） receptor agonists combined with insulin aspart30 on the glucose control and weight of patients with type 2 diabetes mellitus. Methods： 116 patients with type 2 diabetes mellitus were selected as the research objects and were randomly divided into the research group（group A, n=58） and the control group（group B,n=58） by the random number table method. Group B were treated by insulin aspart 30 while group A were treated by insulin aspart 30 combined with liraglutide. Both of the two groups received continuous 24 weeks of treatment. The changes of glucose control indexes,lipid biochemical indexes and body mass index（BMI）, etc. before and after the treatment were compared between the two groups. The differences in the first rates of blood glucose control, total rates of blood glucose control and the incidence of hypoglycemia were recorded. Results： （1） 6 months of treatment later, except that the differences in HDL-C levels in the two groups before and after the treatment were not statistically significant（P〉0.05）, glucose control indexes such as FBG, 2 h PG and Hb A1 c and lipid biochemical indexes such as TG, TC and LDL-C and BMI level were significantly lower than those before the treatment. The decreased range in group A was greater than that in group B（P〈0.05）;（ 2）In group A, the first rate of blood glucose control（70.7%） and total rate of blood glucose control（100.0%） were significantly higher than those in group B（37.9%, 93.1%）（P〈0.05）;（ 3）There were no serious adverse reactions and severe hypoglycemia events in the two groups, in which the incidence of mild hypoglycemia in group A [6.9%（4/58）] was significantly lower than that in group B [24.1%（14/58）]（P〈0.05）. Conclusion： To adopt insulin aspart 30 combined with GLP-1 receptor agonists in the clinical treatment of type 2 diabetes mellitus, the curative effect is definite and the effect of blood glucose control is good.It can effectively improve the blood lipid level, inhibit weight gain, and is good for improving the prognosis of patients.