地特胰岛素联合利拉鲁肽对二甲双胍无效的老年2型糖尿病的疗效

Curative effect of Insulin Ditel combined with Lialuru Peptide on type 2 diabetes in elderly patients with Metformin-resistant

目的探讨地特胰岛素联合利拉鲁肽对二甲双胍无效的老年2型糖尿病(T2DM)的作用。方法回顾性分析2017年10月—2019年4月华中科技大学医院收治的127例对二甲双胍无效的老年T2DM患者的临床资料,根据治疗方法分为A组(采用地特胰岛素治疗40例)、B组(采用利拉鲁肽治疗41例)和C组(采用地特胰岛素联合利拉鲁肽治疗46例)。比较三组患者治疗前后体重指数(BMI)、空腹血糖(FPG)、餐后2 h血糖(2hPBG)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)变化及不良反应。结果治疗前三组BMI、FPG、2hPBG、HbA1c、HOMA-IR比较,差异均无统计学意义(均P>0.05);治疗后三组BMI、FPG、2hPBG、HbA1c、HOMA-IR均较治疗前降低,且治疗后C组的BMI、FPG、2hPBG、HbA1c、HOMA-IR均低于A、B组,差异均有统计学意义(均P<0.05);三组不良反应发生率比较,差异无统计学意义(P>0.05)。结论对二甲双胍无效的老年T2DM患者实施地特胰岛素联合利拉鲁肽治疗可显著降低BMI,改善糖代谢指标,效果明显优于单独使用,且安全。

Objective To investigate the effect of Insulin Ditel combined with Lialuru Peptide on Metformin-resistant elderly patients with type 2 diabetes mellitus(T2DM).Methods From October 2017 to April 2019,the clinical data of 127 elderly patients with T2DM who failed to respond to Metformin treated in Huazhong University of Science and Technology Hospital were retrospectively analyzed.According to the treatment methods,the patients were divided into group A(40 cases treated with Insulin Ditel),group B(41 cases treated with Lialuru Peptide)and group C(46 cases treated with Insulin Ditel combined with Lialuru Peptide).The changes of body mass index(BMI),fasting plasma glucose(FPG),2 h postprandial blood glucose(2hPBG),glycosylated hemoglobin(HbA1c),insulin resistance index(HOMA-IR)among the three groups were compared before and after treatment and the adverse reactions were compared among three groups.Results There were no significant differences in BMI,FPG,2hPBG,HbA1c and HOMA-IR among the three groups before treatment(P>0.05).After treatment,BMI,FPG,2hPBG,HbA1c and HOMA-IR in the three groups were lower than those before treatment,and BMI,FPG,2hPBG,HbA1c and HOMA-IR in group C were lower than those in group A and group B after treatment,with statistically significant differences(all P<0.05).There was no significant difference in the incidence of adverse reactions among the three groups(P>0.05).Conclusion In the elderly T2DM patients with Metformin-resistant,the combination of Insulin Ditel and Lialuru Peptide can significantly reduce BMI and improve the index of glucose metabolism,the effect is better than that of using alone,and it is safe.