利拉鲁肽、达格列净联合二甲双胍片治疗2型糖尿病的症状转归分析及对体重的影响

Symptom outcome analysis of liraglutide and dapagliflozin combined with metformin tablets in the treatment of type 2 diabetes mellitus and its effect on body weight

目的分析利拉鲁肽、达格列净联合二甲双胍片治疗2型糖尿病(T2DM)的症状转归分析及对体重的影响。方法选择医院2017年1月~2020年1月诊治的T2DM伴肥胖患者60例。根据用药不同分为接受达格列净联合二甲双胍片治疗的对照组(n=28)和利拉鲁肽、达格列净联合二甲双胍片治疗的治疗组(n=32)。比较两组患者血脂、血糖、胰岛素抵抗指数(HOMA-IR)、体重、不良反应。结果治疗后,两组患者总胆固醇(TC)、三酰甘油(TG)和低密度脂蛋白(LDL)水平较治疗前降低;其中治疗组患者TC、TG、LDL水平低于对照组(P<0.05)。治疗后,两组患者空腹C肽(FCP)、空腹血糖(FBG)和餐后2h血糖(2hPG)水平较治疗前下降,且治疗组患者FCP、FBG和2hPG水平低于对照组(P<0.05)。治疗后,两组患者HOMA-IR和BMI较治疗前降低,且治疗组患者HOMA-IR和BMI低于对照组(P<0.05)。治疗组不良反应总发生率高于对照组,但差异无统计学意义(P>0.05)。结论利拉鲁肽、达格列净联合二甲双胍片治疗2型糖尿病能促使患者高血糖、高血脂症状转归,并能减轻体重,改善胰岛素抵抗。

Objective To investigate the effect of liraglutide and dapagliflozin combined with metformin tablets on symptom outcome and body weight of patients with type 2 diabetes mellitus(T2DM).Methods Sixty patients with T2DM in our hospital from January 2017 to January 2020 were enrolled,and divided into two groups according to different treatment methods.The control group(n=28)received dapaliflozin combined with metformin tablets,while the treatment group(n=32)received liraglutide and dapagliflozin combined with metformin.Then the blood lipid,blood glucose,HOMA-IR,body weight and adverse reactions were compared between groups.Results After treatment,levels of total cholesterol(TC),triglyceride(TG)and low density lipoprotein(LDL)were decreased in both groups,and the lower in treatment group than those in control group(P<0.05).Meanwhile,there was also a decreasing trend in levels of fasting C-peptide(FCP),fasting blood glucose(FBG)and postprandial 2 h blood glucose(2hPG)after treatment,and levels of those indexes were lower in treatment group than those in control group(P<0.05).The insulin resistance index(HOMA-IR)and BMI were decreased in both groups after treatment,and the decrease was more significant in treatment group than in control group(P<0.05).The adverse reaction rate of treatment group was slightly higher than that of control group,with no statistic difference(P>0.05).Conclusion Application of liraglutide and dapagliflozin combined with metformin tablets can effectively improve the outcome of hyperglycemia and hyperlipidemia,and can reduce body weight and improve insulin resistance for T2DM patients,which is worthy of recommendation.