利拉鲁肽与西格列汀治疗胰岛素控制血糖欠佳的肥胖2型糖尿病患者的临床效果及安全性比较

Comparison of clinical effect and safety of liraglutide and sitagliptin in the treatment of type 2 diabetes mellitus obese patients with poor insulin control of blood glucose

目的对比利拉鲁肽与西格列汀治疗胰岛素控制血糖欠佳的肥胖2型糖尿病患者的临床效果及安全性。方法选取2018年1月至2020年12月收治的84例胰岛素控制血糖欠佳的肥胖2型糖尿病患者为研究对象,按照治疗药物的不同将其分为A组与B组,各42例。A组采用利拉鲁肽进行治疗,B组采用西格列汀进行治疗。比较两组的血糖指标、血脂指标、身体质量指数、腰围、低血糖事件及不良反应发生情况。结果治疗后,两组的FPG、2 h PG水平及HbA1c均较治疗前降低,且A组低于B组(P<0.05)。治疗后,两组的TC、TG、LDL-C、HDL-C、Hcy水平比较,差异无统计学意义(P>0.05)。治疗后,A组的身体质量指数显著低于B组与治疗前(P<0.05),但两组的腰围无显著差异(P>0.05)。两组的低血糖事件发生率比较,差异无统计学意义(P>0.05)。A组的不良反应总发生率显著高于B组(P<0.05)。结论利拉鲁肽、西格列汀均能改善胰岛素控制血糖欠佳的肥胖2型糖尿病患者的腰围,预防低血糖事件的发生;相比于西格列汀,利拉鲁肽可更显著地降低血糖水平及身体质量指数,但其用药后消化道不良反应的发生率较高。

Objective To compare the clinical effect and safety of liraglutide and sitagliptin in the treatment of type 2 diabetes mellitus obese patients with poor insulin control of blood glucose.Methods Eighty-four type 2 diabetes mellitus obese patients with poor insulin control of blood glucose admitted from January 2018 to December 2020 were selected as the research subjects.According to different therapeutic drugs,the patients were divided into group A and group B,with 42 cases in each group.The group A was treated with liraglutide,and the group B was treated with sitagliptin.The blood glucose indexes,blood lipid indexes,body mass index,waist circumference,incidences of hypoglycemic events and adverse reactions were compared between the two groups.Results After treatment,the FPG,2 h PG levels and HbA1c in the two groups were lower than those before treatment,and those in the group A were lower than the group B(P<0.05).After treatment,there were no significant differences in the levels of TC,TG,LDL-C,HDL-C and Hcy between the two groups(P>0.05).After treatment,the body mass index in the group A was significantly lower than that in the group B and before treatment(P<0.05),but there was no significant difference in waist circumference between the two groups(P>0.05).There was no significant difference in the incidence of hypoglycemic events between the two groups(P>0.05).The total incidence of adverse reactions in the group A was significantly higher than that in the group B(P<0.05).Conclusion Liraglutide and sitagliptin can improve the waist circumference of type 2 diabetes mellitus obese patients with poor insulin control of blood glucose,and prevent the incidence of hypoglycemic events.Compared with sitagliptin,liraglutide can significantly reduce the blood glucose level and body mass index,but with higher incidence of gastrointestinal adverse reactions.