度拉糖肽联合甘精胰岛素治疗肥胖2型糖尿病的疗效分析

Efficacy Analysis of Dulaglutide Combined with Insulin Glargine in the Treatment of Obese Type 2 Diabetes Mellitus

目的 观察度拉糖肽联合甘精胰岛素治疗肥胖2型糖尿病患者的临床疗效和安全性。方法 选取2021年5—12月吉林市化工医院诊治的肥胖2型糖尿病患者40例,随机分成研究组及对照组,每组20例。两组均根据血糖情况皮下注射甘精胰岛素注射液,研究组在此基础上皮下注射度拉糖肽1.5 mg,1次/周,12周后比较两组治疗前后空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)、体质量等变化情况及不良反应。结果 治疗12周后,两组患者FPG、2 hPG、HbA1c均较治疗前明显下降,差异有统计学意义(P<0.05);研究组体质量较治疗前下降,差异有统计学意义(P<0.05);研究组2 hPG、HbA1c均低于对照组,差异有统计学意义(P<0.05)。两组患者均无明显低血糖发生。研究组在治疗过程中有4例腹胀、3例恶心、2例腹泻,症状较轻,2周左右均自行缓解。对照组1例腹胀,症状轻,自行缓解。结论 血糖控制不佳的肥胖2型糖尿病患者,度拉糖肽联合甘精胰岛素治疗,能有效降低血糖,减轻体质量,且未增加低血糖发生,安全性良好。

Objective To observe the clinical efficacy and safety of dulaglutide combined with insulin glargine in the treatment of obese patients with type 2 diabetes.Methods A total of 40 obese patients with type 2 diabetes who were diagnosed and treated in Jilin Chemical Hospital from May to December 2021 were selected and randomly divided into a study group and a control group,20 in each group.Both groups were subcutaneously injected with insulin glargine injection according to the blood glucose condition,and the study group was subcutaneously injected with dulaglutide 1.5 mg on this basis,once a week.After 12 weeks,the changes of fasting blood glucose(FPG),2 h postprandial blood glucose(2 hPG),glycosylated hemoglobin(HbA1 c),body weight and adverse reactions were compared between the two groups before and after treatment.Results After 12 weeks of treatment,FPG,2 hPG and HbA1 c in the two groups were significantly decreased compared with those before treatment,and the difference was statistically significant(P<0.05).The body weight of the study group decreased compared with that before treatment,and the difference was statistically significant(P<0.05).The 2 hPG and HbAlc of the study group were lower than those of the control group,and the difference was statistically significant(P<0.05).No obvious hypoglycemia occurred in the two groups of patients,there were 4 cases of abdominal distension,3 cases of nausea,and 2 cases of diarrhea in the study group during the treatment process.In the control group,there was 1 case of abdominal distension,the symptoms were mild and relieved spontaneously.Conclusion In obese patients with type 2 diabetes mellitus with poor blood glucose control,dulaglutide combined with insulin glargine therapy can effectively reduce blood glucose and reduce body weight without increasing the occurrence of hypoglycemia,with good safety.