速效胰岛素联合利拉鲁肽在老年2型糖尿病患者中应用效果

Effects of rapid-acting insulin combined with liraglutide in elderly patients with type 2 diabetes

目的探讨速效胰岛素强化降糖后联合利拉鲁肽对老年2型糖尿病患者胰岛功能及血清成纤维细胞生长因子-21(FGF-21)、糖类抗原125(CA125)水平的影响。方法选取阜南县人民医院102例老年2型糖尿病患者作为研究对象。采用随机数字表法分为观察组和对照组各51例。对照组予以速效胰岛素强化降糖治疗,并于强化治疗后根据老年患者特点、病程、血糖特点、并发症等情况给予口服降糖药进行后续治疗。观察组在对照组治疗基础上于强化治疗后加用利拉鲁肽治疗,均治疗3个月。比较两组血糖[空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)]、血脂[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、体质量[包括体质量指数(BMI)]控制情况、治疗前后空腹胰岛素(FIns)、C肽(FCP)及胰岛功能[胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)]、血清FGF-21、CA125水平、不良反应发生率。结果治疗后观察组FPG、2 h PG、HbAlc水平、TC、TG、LDL-C水平、体质量、BMI均低于对照组,HDL-C高于对照组,差异有统计学意义(t=5.224,7.315,10.285,10.986,3.767,5.337,2.541,2.465,7.807,P<0.05);治疗后观察组FINS、FCP、HOMA-β水平高于对照组,HOMA-IR水平低于对照组,差异有统计学意义(t=2.359,4.677,10.474,2.949,P<0.05);治疗后观察组血清FGF-21、CA125水平低于对照组,差异有统计学意义(t=4.081,3.142,P<0.05);两组不良反应发生率比较,差异无统计学意义(χ^(2)=0.297,P>0.05)。结论速效胰岛素联合利拉鲁肽可调节老年2型糖尿病患者糖脂代谢,增强胰岛功能,减轻体质量,疗效确切、安全性良好。

Objective To investigate the effect of rapid-acting insulin-enhanced hypoglycemic therapy combined with liraglutide on islet function and serum fibroblast growth factor-21(FGF-21)and carbohydrate antigen 125(CA125)levels in elderly patients with type 2 diabetes.Methods A total of 102 elderly patients with type 2 diabetes in Funan County People's Hospital were selected as the research objects.Random number table method was used to divide them into the observation group and the control group with 51 cases in each group.The control group was given rapid-acting insulin intensive hypoglycemic therapy,after intensive treatment,the elderly patients were given oral hypoglycemic agents for follow-up treatment according to their characteristics,course of disease,blood glucose characteristics,complications and other conditions.The observation group was treated with lilarutide on the basis of the control group after intensive treatment,and both were treated for 3 months.The blood glucose[fasting blood glucose(FPG),2h postprandial blood glucose(2h PG),glycated hemoglobin(HbA1c)],blood lipids[total cholesterol(TC),triacylglycerol(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)],control of body mass[including body mass index(BMI)],fasting insulin(FIns),C peptide(FCP)and islet function[insulin resistance index(HOMA-IR),islet β-cell function index(HOMA-β)],serum FGF-21,CA125 levels,incidence of adverse reactions before and after treatment between the two groups were compared.Results After treatment,the levels of FPG,2h PG,HbAlc,TC,TG,LDL-C,body mass,and BMI in the observation group were lower than those in the control group,while HDL-C was higher than that in the control group,with a statistically significant difference(t=5.224,7.315,10.285,10.986,3.767,5.337,2.541,2.465,7.807,P<0.05).After treatment,the levels of FINS,FCP,HOMA-βin the observation group were higher than those in the control group,and the HOMA-IR level is lower than that in the control group,with a statistically significant difference(t=2.359,4.677,10.474,2.949,P<0.05).After treatment,the levels of serum FGF-21 and CA125 in the observation group were lower than those in the control group,with a statistically significant difference(t=4.081,3.142,P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(χ^(2)=0.297,P>0.05).Conclusion Rapid-acting insulin combined with lilalutide can regulate glucose and lipid metabolism in elderly patients with type 2 diabetes,enhance the function of islets of langerhans,and reduce body weight,and have definite efficacy and safe.