轻断食及利拉鲁肽治疗新诊断超重/肥胖2型糖尿病的疗效及安全性比较

Comparison of clinical efficacy and safety of intermittent fasting and liraglutide in newly diagnosed overweight/obese type 2 diabetes mellitus

目的比较轻断食及利拉鲁肽对新诊断超重/肥胖2型糖尿病患者的疗效及安全性。方法选取2021年1~8月在保定市第一中心医院确诊的150例新诊断超重/肥胖2型糖尿病患者,采用随机数字表法将患者分为对照组(盐酸二甲双胍+利拉鲁肽)与试验组[盐酸二甲双胍+轻断食(一周中任选5天作为非断食日,相对自由进食,其他任意非连续的两天作为断食日)],各75例。治疗12周,比较两组治疗前后空腹血清胰岛素、身体质量指数(BMI)、糖脂代谢及血压的变化情况,记录两组低血糖、上消化道反应等不良反应发生情况。结果两组治疗前BMI、空腹血清胰岛素、胰岛素抵抗指数(HOMA-IR)、空腹血糖(FPG)、糖化血红蛋白、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)、收缩压(SBP)比较,差异均无统计学意义(P>0.05)。两组患者治疗前后BMI(t=10.029,P<0.001)、空腹血清胰岛素(t=2.320,P=0.023)、糖化血红蛋白(t=2.329,P=0.033)差值比较,差异均有统计学意义(P<0.05)。试验组总不良反应发生率为13.89%,对照组为24.63%,两组差异无统计学意义(χ^(2)=1.271,P=0.535)。结论轻断食及利拉鲁肽治疗新诊断超重/肥胖2型糖尿病可明显降低患者血糖和体质量,改善胰岛β细胞功能,安全性较好。

Objective To investigate the efficacy and safety of intermittent calorie restriction and liraglutidein the treatment of newly diagnosed overweight/obese type 2 diabetes melltus(T2DM).Methods A total of 150 patients with newly diagnosed overweight/obese T2DM admitted to the Department of Endocrinology of Baoding NO.1 Central Hospital from January to August 2021 were included in this study.They were divided into the control group(metformin and liraglutide)and the experimental group[metformin and intermittent energy restriction(inconsecutive days for two of a week were chosen as fasting days,the other five days as feeding days,relatively free to eat)]according to the table of random number,with 75 patients in each group.After 12-week treatment,fasting serum insulin,body mass index,blood pressure and other metabolic indicators of glucose and serum lipid were compared before and after treatment.Efficacy and adverse reactions such as hypoglycemia and discomfort of upper gastrointestinal were recorded.Results There was no significant difference in baseline information such as body mass index(BMI),fasting serum insulin,insulin resistance index(HOMA-IR),fasting plasma glucose(FPG),glycosylated hemoglobin,triglyceride(TG),total cholesterol(TC),low density lipoprotein(LDL-C)and systolic blood pressure(SBP)(P>0.05).The difference inbody mass index(BMI)(t=10.029,P<0.001),fasting serum insulin(t=2.320,P=0.023)and glycosylated hemoglobin(t=2.329,P=0.033)between the two groups before and after treatment was statistically significant(P<0.05).There was no significant difference in the incidence of total adverse reactions between the two groups(χ^(2)=1.271,P=0.535).The total incidence of adverse reactions was 13.89%in the experimental group and 24.63%in the control group.Conclusions The treatment of intermittent calorie restriction and lirglutide in newly diagnosed overweight/obese T2DM can significantly reduce blood glucose and body weight,improve function ofβ-cell,without serious adverse reactions.