传统能量限制饮食联合GLP-1 RAs艾塞那肽治疗2型糖尿病伴超重或肥胖患者的临床效果

Clinical effect of traditional energy restriction diet combined with GLP-1 RAs exenatide in treatment of type 2 diabetes mellitus with overweight or obesity

目的探讨传统能量限制饮食联合胰高血糖素样肽-1受体激动剂(GLP-1 RAs)艾塞那肽治疗2型糖尿病伴超重或肥胖患者的临床效果。方法选取2018年6月至2020年10月我院收治的80例2型糖尿病伴超重或肥胖患者作为研究对象,采用计算机生成随机序列的方式,按照1∶1的比例将其随机分为对照组和试验组,试验期间,6例患者因个人原因或依从性较差而退出研究,最终分析共纳入74例患者,每组37例。对照组给予普通糖尿病饮食联合磺脲类药物治疗,试验组给予能量限制饮食联合艾塞那肽治疗。干预12周后,比较两组患者的BMI、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、C肽、血清胰岛素、血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)水平。结果干预后,试验组的减重效果优于对照组,差异具有统计学意义(P<0.05)。干预后,试验组的FBG和HbA1c水平相较于干预前均显著下降,其中FBG下降(0.91±2.25)mmol/L,HbA1c下降(0.66±1.01)%,差异具有统计学意义(P<0.05);两组的HbA1c、血清胰岛素水平干预前、后差值比较,差异具有统计学意义(P<0.05)。干预后,试验组的血清TC、TG和LDL-C水平相较于干预前显著下降,下降水平分别为(0.46±0.74)、(0.17±0.29)、(0.26±0.50)mmol/L,差异具有统计学意义(P<0.05);两组的TC水平干预前、后差值比较,差异具有统计学意义(P<0.05)。结论能量限制饮食联合艾塞那肽可降低超重或肥胖2型糖尿病患者的体重,改善血糖和血脂代谢,有利于控制患者的病情。

Objective To investigate the clinical effect of traditional energy restriction diet combined with glucagon like peptide-1 receptor agonist(GLP-1 RAs) exenatide in the treatment of type 2 diabetes mellitus with overweight or obesity.Methods From June 2018 to Octorber 2020,80 cases of type 2 diabetes mellitus with overweight or obesity were selected as the research objects,using computer-generated random sequences,the patients were randomly divided into control group and experimental group according to the ratio of 1 ∶1.Six patients were withdrawn from the study for personal reasons or poor compliance during experiment.The final analysis included 74 patients,with 37 cases in each group.The control group was given general diabetes diet combined with sulfonylureas,while the experimental group was given energy restriction diet combined with exenatide treatment.After 12 weeks of intervention,the BMI,levels of fasting blood glucose(FBG),glycosylated hemoglobin(HbA1 c),C-peptide,serum insulin,serum total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C) and low density lipoprotein cholesterol(LDL-C) were compared between the two groups.Results After intervention,the weight loss effect of the experimental group was better than that of the control group,and the difference was statistically significant(P<0.05).After intervention,the levels of FBG and HbA1 c in the experimental group decreased significantly compared with those before intervention,in which FBG decreased by(0.91 ±2.25) mmol/L and HbA1 c decreased by(0.66±1.01)%,and the differences were statistically significant(P<0.05);the differences of differences of HbA1 c and serum insulin levels before and after intervention between the two groups were statistically significant(P <0.05).After intervention,the levels of serum TC,TG and LDL-C in the experimental group decreased significantly compared with those before intervention,and the decreased levels were(0.46 ±0.74),(0.17±0.29),(0.26±0.50) mmol/L respectively,and the differences were statistically significant(P<0.05).The difference of difference of TC level before and after intervention between the two groups was statistically significant(P<0.05).Conclusion Energy restriction diet combined with exenatide can reduce body weight,improve blood glucose and lipid metabolism in overweight or obese patients with type 2 diabetes,and help control the condition of patients.