短期胰岛素泵强化治疗后超重、肥胖2型糖尿病患者联合用药的回顾性分析

A Retrospective Analysis of Combination Therapy in Overweight and Obese Patients with Type 2 Diabetes after Short-Term Intensive Insulin Pump Therapy

目的探讨短期胰岛素泵强化治疗后超重、肥胖2型糖尿病(type 2 diabetes mellitus,T2DM)患者的联合用药情况,分析其疗效差异。方法回顾性选取2022年9月—2023年9月淄博市张店区人民医院收治的86例初诊为T2DM的超重、肥胖患者的临床资料,所有患者均接受短效胰岛素泵强化治疗,为期1周,治疗结束后进行联合用药。根据用药差异将患者分为A组(n=43,二甲双胍+甘精胰岛素)与B组(n=43,二甲双胍+利拉鲁肽),所有患者均持续用药12周以上,比较两组血糖指标、胰岛细胞检测结果、减重情况、血脂指标、用药期间不良反应发生情况。结果持续给药12周后,A组空腹血糖、餐后2 h血糖水平低于B组,差异有统计学意义(P均<0.05)。A组体重指数、总胆固醇与甘油三酯水平、胰岛β细胞功能指数均高于B组,胰岛素抵抗指数低于B组,差异有统计学意义(P均<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论对超重、肥胖T2DM患者,在短期胰岛素泵强化治疗后,以二甲双胍为基础,联用甘精胰岛素有助于维持血糖指标的稳定性,改善患者胰岛功能,而利拉鲁肽在减重以及调节患者血脂指标等方面具有一定的优势。

Objective To investigate the efficacy of insulin pump combination therapy in overweight and obese pa-tients with type 2 diabetes mellitus(T2DM)after short-term intensive insulin pump therapy.Methods The clinical data of 86 overweight and obese patients with a primary diagnosed of T2DM admitted to Zhangdian District People′s Hospital from September 2022 to September 2023 were retrospectively selected.All patients received short-acting in-sulin pump intensive therapy for 1 week,and combined medication was performed after treatment.According to the difference of medication,the patients were divided into group A(n=43,metformin+insulin glargine)and group B(n=43,metformin+liraglutide).All patients were treated for more than 12 weeks.The blood glucose indexes,islet cell test results,weight loss,blood lipid indexes,and adverse reactions during medication were compared between the two groups.Results After 12 weeks of continuous administration,the fasting plasma glucose and 2-hour postprandial plasma glucose levels in group A were lower than those in group B,and the differences were statistically significant(all P<0.05).Group A body mass index,total cholesterol and triglyceride levels,islet beta cell function index were higher than group B,insulin resistance index is lower than that of group B,and the differences were statistically sig-nificant(all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion For overweight and obese T2DM patients,after short-term intensive treatment with insulin pump,metformin-based coadministration of glycemic insulin helps to maintain the stability of blood glucose index and improve the patients′pancreatic islet function,whereas liraglutide has certain advantages in weight reduction as well as regulation of patients′lipid index.