德谷胰岛素联合利拉鲁肽在血糖控制不佳的2型糖尿病中的应用价值研究

Application Value of Insulin Degludec Combined with Liraglutide in Type 2 Diabetes Mellitus with Poor Blood Glucose Control

目的探讨对血糖控制不佳2型糖尿病患者采用德谷胰岛素联合利拉鲁肽治疗的临床效果。方法选取2021年3月—2023年11月山东颐养健康集团莱芜中心医院收治的72例血糖控制不佳的2型糖尿病患者为研究对象,根据不同治疗方法分为对照组(36例,选择甘精胰岛素+谷赖胰岛素治疗)和研究组(36例,选择德谷胰岛素+利拉鲁肽治疗)。比较两组治疗总有效率、基础胰岛素用量、糖化血红蛋白水平、空腹血糖水平、空腹血清C肽(fasting serum C-peptide,FCP)水平、胰岛素抵抗指数(homeostasis model assessment-IR,HOMA-IR)、餐后2 h血清C肽(2-hour postprandial serum C-peptide,2 hPCP)水平、不良反应(恶心、低血糖、腹泻腹胀)总发生率。结果研究组治疗总有效率高于对照组,不良反应总发生率和基础胰岛素用量低于对照组,差异有统计学意义(P均<0.05)。治疗后,研究组糖化血红蛋白、空腹血糖、FCP、HOMA-IR、2 hPCP水平均优于对照组,差异有统计学意义(P均<0.05)。结论临床针对血糖控制不佳2型糖尿病患者采取德谷胰岛素联合利拉鲁肽药物治疗,可改善血糖水平,提升安全性,疗效较高。

Objective To investigate the clinical effect of insulin degludec combined with liraglutide in patients with type 2 diabetes mellitus with poor blood glucose control.Methods A total of 72 patients with type 2 diabetes mellitus with poor blood glucose control admitted to Laiwu Central Hospital,Shandong Health Care Group from March 2021 to November 2023 were selected as the research objects.According to different treatment methods,they were divided into control group(36 cases,treated with insulin glargine+insulin glulisine)and study group(36 cases,treated with insulin degludec+liraglutide).The total effective rate,basal insulin dosage,glycated hemoglobin A1c level,fasting blood glucose level,fasting serum C-peptide(FCP)level,homeostasis model assessment-IR(HOMA-IR),2-hour postprandial serum C-peptide(2 hPCP)level and total incidence of adverse reactions(nausea,hypoglycemia,abdomi-nal distension and diarrhea)were compared between the two groups.Results The total effective rate of treatment in the study group was higher than that in the control group,the total incidence of adverse reactions and the dosage of ba-sic insulin in the study group were lower than those in the control group,the differences were statistically significant(all P<0.05).After treatment,the levels of glycated hemoglobin A1c,fasting blood glucose,FCP,HOMA-IR and 2 hPCP in the study group were better than those in the control group,and the differences were statistically significant(all P<0.05).Conclusion The combination of insulin degludec and liraglutide in the treatment of type 2 diabetes mellitus with poor blood glucose control can improve the blood glucose level and safety,and have high efficacy.