GLP-1类似物与甘精胰岛素分别联合盐酸二甲双胍治疗2型糖尿病的疗效及药物经济学比较

Comparison of the Efficacy and Pharmacoeconomics of GLP-1 Analogues and Insulin Glargine Combined with Metformin Hydrochloride in the Treatment of Type 2 Diabetes Mellitus

目的:比较人胰高血糖素样肽-1(GLP-1)类似物与甘精胰岛素分别联合盐酸二甲双胍治疗2型糖尿病(T2DM)的疗效及药物经济学,旨在为临床应用提供参考。方法:前瞻性选取2019年1月—2020年1月本院收治的128例患者,简单随机化分为对照组和观察组各64例。两组均给予盐酸二甲双胍。在此基础上,对照组采用甘精胰岛素,观察组采用GLP-1类似物。治疗12周后,比较两组空腹血糖(FBG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)、超氧化物歧化酶(SOD)、丙二醛(MDA)、药物经济学、不良反应等。结果:治疗后,观察组2hPG低于对照组(P<0.05),组间FBG、HbA1c比较,差异无统计学意义(P>0.05);观察组SOD较对照组高,MDA较对照组低(P<0.05);观察组不良反应发生率为3.13%(2/64),与对照组的1.56%(1/64)比较,差异无统计学意义(P>0.05)。结论:与甘精胰岛素相比,GLP-1类似物联合盐酸二甲双胍治疗T2DM,在降低2hPG、改善机体氧化应激、成本-效果方面更具优势。

Objective:To compare the efficacy and pharmacoeconomics of human glucagon-like peptide-1(GLP-1)analogues and insulin glargine combined with metformin hydrochloride in the treatment of type 2 diabetes mellitus(T2DM),aiming to provide clinical applications reference.Methods:From January 2019 to January 2020,128 patients admitted to our hospital were prospectively selected.They were divided into two groups according to simple randomization,each with 64 cases.Both groups were given metformin hydrochloride.On this basis,the control group was given insulin glargine,and the observation group was given GLP-1 analogues.The fasting blood glucose(FBG),2h postprandial blood glucose(2hPG),glycosylated hemoglobin(HbA1c),superoxide dismutase(SOD),malondialdehyde(MDA)after 12 weeks of treatment,pharmacoeconomics,and adverse reactions were compared between the two groups.Results:After treatment,the 2hPG in the observation group was lower than that in the control group(P<0.05).There was no significant difference in FBG and HbA1c between the groups after treatment(P>0.05).The SOD of the observation group after treatment was higher than that of the control group,and the MDA was lower than that of the control group(P<0.05).The incidence of adverse reactions in the observation group was 3.13%(2/64),compared with 1.56%(1/64)in the control group,the difference was not statistically significant(P>0.05).Conclusion:Compared with insulin glargine,GLP-1 analogue combined with metformin hydrochloride in the treatment of T2DM has advantages in reducing 2hPG,improving oxidative stress,and cost-effectiveness.