利拉鲁肽联合甘精胰岛素对新诊断2型糖尿病的疗效观察

Efficacy observation of liraglutide combined with glargine insulin in treatment of newly diagnosed type 2 diabetes mellitus

目的探讨利拉鲁肽联合甘精胰岛素治疗新诊断2型糖尿病患者的疗效。方法选取南方医科大学附属潮州中心医院内分泌科2014年8月至2015年12月新诊断2型糖尿病患者61例,按照随机数字表法分为两组。观察组(29例)给予利拉鲁肽联合甘精胰岛素治疗,对照组(32例)给予胰岛素强化治疗,分析比较两组治疗前后的疗效。结果治疗12周后,所有患者空腹血糖(FPG)、餐后2h血糖(PPG)、糖化血红蛋白(HbA1c)、空腹C肽(FCP)、餐后2hC肽(PCP)、胰岛素抵抗指数(HOMAIR)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)和体质量指标均有所下降,而胰岛β细胞功能指数(HOMA-β)、高密度脂蛋白胆固醇(HDL-C)均有所上升,两种治疗方法均安全有效。观察组起效较快,在治疗4周后,上述各项指标较治疗前均明显改善;观察组在治疗4、12周后,上述指标均显著优于对照组,差异有统计学意义(P<0.05)。结论利拉鲁肽联合甘精胰岛素在降糖、调脂、降体质量和胰岛功能恢复方面都显著优于胰岛素强化治疗。

Objective To investigate the effect of liraglutide combined with glargine insulin in treating the patients with new- ly diagnosed type 2 diabetes mellitus （T2DM）. Methods Sixty-one cases of newly diagnosed T2DM in the endocrinology depart- ment of Affiliated Chaozhou Central Hospital of Southern Medical University, from August 2014 to December 2015 were selected and divided into two groups according to the random number table. The observation group （29 cases） was treated with liraglutide combined with glargine insulin and the control group （32 cases） was given the intensive insulin therapy. The curative eifects before and after treatment were analyzed and compared between the two groups. Results The fast plasma glucose（FPG） ,postprandial 2 h blood glucose（PPG）,glyeosylated hemoglobin（H bAle）, fasting C peptide（FCP）, postprandial 2 h C peptide（PCP）, insulin resist anee index（HOMA-IR）,blood lipid indicators and body mass index after 12-week treatment were decreased in the treatment and follow up periods,while pancreatic ~ cell function index （HOMA-β） and HDL-C were increased,indicating that the two kinds of treatment method all were effective. The effect onset in the observation group was faster,the above indexes after 4-week treatment were significantly improved compared with before treatment. The above indexes after 4-, 12-week treatment in the observation group were significantly superior to those in the control group,the difference was statistically significant（P〈0.05）. Conclusion Liraglu- tide combined with glargine insulin has better effect in the aspects of reducing blood glucose, regulating blood lipid, decreasing the body mass and islet function recovery than the intensive insulin treatment and is worthy of clinical promotion and application.