利拉鲁肽与胰岛素泵对新诊断的2型糖尿病肥胖患者临床疗效比较

Comparison of clinical efficacy of Liraglutide and Insulin pump in newly diagnosed obese patients with type 2 diabetes mellitus

目的比较利拉鲁肽与胰岛素泵持续皮下输注(CSII)对新诊断的2型糖尿病肥胖患者的疗效。方法选取2015年10月~2016年10月我科收治的新诊断且未经任何降糖药物治疗的64例2型糖尿病肥胖患者作为研究对象,随机分为利拉鲁肽皮下注射组和胰岛素泵持续泵入组,均治疗4周。比较两组患者治疗前后空腹及餐后2 h的血糖、空腹胰岛素、糖化血红蛋白、体重指数及腰围变化等情况。结果两组患者治疗后空腹血糖(FPG)、餐后2 h血糖(2 h PG)、空腹胰岛素(FINS)、糖化血红蛋白(Hb A1c)均较同组治疗前显著改善,组间比较差异无统计学意义(P>0.05);利拉鲁肽组体重指数(BMI)及腰围较治疗前显著改善,与胰岛素泵组比较,差异有统计学意义(P<0.05)。结论对于新诊断的2型糖尿病肥胖患者,应用利拉鲁肽降糖治疗,可有效降低血糖水平,改善胰岛β细胞的功能,与胰岛素泵降糖的疗效相当,并且有减轻体重及腰围的优势。

Objective To compare the efficacy of Liraglutide and continuous subcutaneous Insulin infusion （CSII） via pump in newly diagnosed obese patients with type 2 diabetes mellitus.Methods From October 2015 to October 2016,a total of 64 patients with newly-diagnosed type 2 diabetes mellitus （DM） without application of antidiabetic drugs treat- ed in our department were randomly divided into Liraglutide hypodermic injection group and continuous Insulin pump group.The treatment was lasted for 4 weeks.The fasting and 2-hour postprandial blood glucose,Insulin level in fasting, glycosylated hemoglobin （HbAlc）,body mass index （BMI）,and Waist circumference were compared before and after treat- ment between the two groups.Results The fasting plasma glucose （FPG）,2-hour postprandial blood glucose （2 h PG）,fast- ing Insulin （FINS）,and HbAlc were significantly improved in the two groups compared with those before treatment,but there was no significant difference in inter-group comparisons.The BMI and waist circumference in Liraglutide group were obviously improved compared with those before treatment,and also displayed statistical differences in comparison of Insulin pump group.Conclusion For the newly diagnosed obese patients with type 2 diabetes,the application of Li- raglutide for blood glucose reduction can effectively reduce the blood glucose level,improve the function of islet [3 cells, and the effect is tantamount to that by Insulin pump.The former has the advantages of reducing body weight and waist circumference.