度拉糖肽对二甲双胍控制不佳的2型糖尿病患者血糖波动和微炎症状态的影响

Effects of Dulaglutide on glycemic variability and microinflammatory state in patients with type 2 diabetes mellitus poorly controlled with Metformin

目的探究度拉糖肽对二甲双胍控制不佳的2型糖尿病患者血糖波动和微炎症状态的影响。方法选取南通大学附属如皋人民医院2019年1月至2022年1月收治的118例单用二甲双胍控制不佳的2型糖尿病患者作为研究对象,采用随机数字表法将其分为对照组和研究组,每组59例。对照组予以二甲双胍联合门冬胰岛素30治疗,研究组在对照组基础上予以度拉糖肽。两组均于治疗3个月后评估血糖生化指标、炎症指标、胰岛功能指标及药物安全性。结果治疗后,两组空腹血糖、餐后2 h血糖、糖化血红蛋白均低于治疗前,葡萄糖目标范围内时间占比(TIR)高于治疗前,且研究组TIR高于对照组(P<0.05)。治疗后,两组白细胞介素-6、超敏C反应蛋白水平低于治疗前,且研究组低于对照组(P<0.05)。治疗后,两组胰岛β细胞稳态模型评估指数(HOMA-β)高于治疗前,胰岛素抵抗稳态模型评估指数(HOMA-IR)低于治疗前,研究组HOMA-β高于对照组,HOMA-IR低于对照组(P<0.05)。研究组恶心、呕吐发生率高于对照组(P<0.05)。结论度拉糖肽应用于二甲双胍控制不佳的2型糖尿病的治疗中有助于控制血糖波动,抑制炎症因子表达,但可能会增加恶心、呕吐发生。

Objective To investigate the effects of Dulaglutide on glycemic variability and microinflammatory state in patients with type 2 diabetes mellitus poorly controlled by Metformin.Methods A total of 118 patients with type 2 diabetes mellitus who were poorly controlled by metformin alone in Rugao People’s Hospital,Nantong University from January 2019 to January 2022 were selected as the research objects.They were divided into control group and study group by random number table method,with 59 cases in each group.The control group was treated with Metformin combined with Insulin Aspart 30,and the study group was treated with Dulaglutide on the basis of the control group.Blood glucose biochemical indexes,inflammatory indexes,islet function indexes,and drug safety were evaluated after three months of treatment in both groups.Results After treatment,the fasting blood glucose,2-hour postprandial blood glucose,and glycosylated hemoglobin of the two groups were lower than those before treatment,and the proportion of time in range(TIR)of glucose target was higher than that before treatment,and the TIR of the study group was higher than that of the control group(P<0.05).After treatment,the levels of interleukin-6 and high-sensitivity C-reactive protein in two groups were lower than those before treatment,and those in the study group were lower than those in the control group(P<0.05).After treatment,homeostasis model assessment index of isletβcell(HOMA-β)in both groups were higher than those before treatment,homeostasis model assessment index of insulin resistance(HOMA-IR)were lower than those before treatment,HOMA-βin study group was higher than that in control group,HOMA-IR was lower than that in control group(P<0.05).The incidence of nausea and vomiting in the study group was higher than that in the control group(P<0.05).Conclusion The application of Dulaglutide in the treatment of patients with type 2 diabetes mellitus poorly controlled by Metformin can help to control blood glucose fluctuation and inhibit the expression of inflammatory factors,but it may increase nausea and vomiting.