利拉鲁肽联合地特胰岛素治疗肥胖2型糖尿病的临床效果及安全性研究

Study on clinical effect and safety of liraglutide combined with insulin detemir in the treatment of obese type 2 diabetes

目的 探究利拉鲁肽联合地特胰岛素治疗肥胖2型糖尿病的临床效果及安全性。方法 60例肥胖2型糖尿病患者,依据入院日期单双号分为实验组与参照组,各30例。参照组采用单纯地特胰岛素治疗,实验组采用利拉鲁肽联合地特胰岛素治疗。比较两组治疗前后相关指标[空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)、胰岛素使用剂量、体质量、体质量指数(BMI)、总胆固醇、甘油三酯、低密度脂蛋白],空腹及餐后30 min、1 h、2 h、3 h的C肽水平,药物不良反应发生情况。结果 治疗后,两组患者FBG、2 h PG、HbA1c、胰岛素使用剂量、体质量、BMI、总胆固醇、甘油三酯、低密度脂蛋白水平均低于本组治疗前,且实验组低于参照组,差异均有统计学意义(P<0.05)。餐后30 min及1、2、3 h,实验组C肽水平分别为(1.66±0.33)、(1.84±0.29)、(1.77±0.34)、(1.75±0.52)nmol/L,均高于参照组的(1.42±0.31)、(1.60±0.20)、(1.60±0.29)、(1.09±0.35)nmol/L,差异有统计学意义(P<0.05)。实验组药物不良反应发生率3.33%低于参照组的26.67%,差异有统计学意义(P<0.05)。结论 肥胖2型糖尿病患者采用利拉鲁肽联合地特胰岛素治疗,可降低血糖水平,减少胰岛素剂量,体质量、血脂水平控制理想,提升餐后C肽水平,减少用药不良反应。

Objective To investigate the clinical effect and safety of liraglutide combined with insulin detemir in the treatment of obese type 2 diabetes.Methods A total of 60 obese patients with type 2 diabetes mellitus were divided into experimental group and reference group according to the odd-even date of admission,with 30 cases in each group.The reference group was treated with insulin detemir alone,and the experimental group was treated with liraglutide and insulin detemir.Both groups were compared in terms of relevant indexes[fasting blood glucose(FBG),2 h postprandial glucose(2 h PG),glycosylated hemoglobin(HbA1c),insulin dosage,body mass,body mass index(BMI),total cholesterol,triglyceride and low density lipoprotein]before and after treatment,level of C-peptide during fasting,30 min,1 h,2 h and 3 h postprandial,and the occurrence of adverse drug reactions.Results After treatment,the levels of FBG,2 h PG,HbA1c,insulin dosage,body mass,BMI,total cholesterol,triglyceride and low density lipoprotein in the two groups were lower than those before treatment in this group,and the experimental group was lower than the reference group.The differences were statistically significant(P<0.05).At 30 min,1 h,2 h and 3 h postprandial,the C-peptide levels of the experimental group were(1.66±0.33),(1.84±0.29),(1.77±0.34)and(1.75±0.52)nmol/L,which were higher than those of(1.42±0.31),(1.60±0.20),(1.60±0.29)and(1.09±0.35)nmol/L in the reference group,and the difference was statistically significant(P<0.05).The incidence of adverse drug reactions in the experimental group was 3.33%,which were lower than that of 26.67%in the reference group,and the difference was statistically significant(P<0.05).Conclusion The treatment of obesity type 2 diabetes patients with liraglutide and insulin detemir can reduce the blood glucose level,reduce the insulin dosage,control the body weight,body mass,blood lipid indicators,improve the level of postprandial C peptide,reduce adverse drug reactions.