度拉糖肽治疗超重/肥胖2型糖尿病对糖脂代谢、体质量及内脏脂肪指数的影响

Effects of dulaglutide on glucose and lipid metabolism,body mass and visceral fat index in overweight/obese type 2 diabetes

目的 探讨度拉糖肽联合二甲双胍治疗超重/肥胖2型糖尿病对患者糖脂代谢、内脏脂肪指数的影响.方法 选择2022年1月-2024年6月天津市红桥医院体检或者门诊病房收治的超重/肥胖2型糖尿病患者90例进行前瞻性研究,按照随机数字表法原则分成观察组与对照组,每组患者各45例.对照组采取单纯二甲双胍治疗,观察组则在对照组的基础上加用度拉糖肽治疗.两组均持续治疗6个月,治疗期间予以用药指导、饮食指导及运动指导.比较两组治疗前后糖脂代谢指标[空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)、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)]、体质量指数(BMI)与内脏脂肪指数指标变化,同时对比两组患者不良反应发生情况.结果 治疗3个月,观察组患者FPG、2hPG、HbA1c、TC、TG、LDL-C、BMI、内脏脂肪指数均低于对照组,差异具有统计学意义(P<0.05);治疗3个月,观察组患者HDL-C水平高于对照组,差异具有统计学意义(P<0.05).观察组患者不良反应总发生率为13.33%,与对照组11.11%的总发生率比较,差异无统计学意义(P>0.05).结论 对于超重/肥胖2型糖尿病患者,采取度拉糖肽联合二甲双胍治疗方式可以显著改善患者糖脂代谢指标,降低BMI与内脏脂肪指数指标水平,且治疗期间不良反应少,值得推广.

Objective To investigate the effect of dulaglutide combined with metformin on glucose and lipid metabolism and visceral fat index in overweight/obese type 2 diabetes patients.Methods A total of 90 overweight/obese type 2 diabetes patients admitted for physical examination or outpatient ward in Tianjin Hongqiao Hospital from January 2022 to June 2024 were selected for prospective study.They were divided into observation group and control group according to the principle of random number table,with 45 patients in each group.The control group was treated with metformin alone,and the observation group was treated with duloglucopeptide on the basis of the control group.Both groups were treated continuously for 6 months,during which medication guidance,diet guidance and exercise guidance were given.The changes of glucose and lipid metabolism indexes[fasting blood glucose(FPG),2h postmeal blood glucose(2hPG),glycated hemoglobin(HbA1c),total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)],body mass index(BMI)and visceral fat index of the two groups before and after treatment were compared.At the same time,the occurrence of adverse reactions was compared between the two groups.Results After 3 months of treatment,the observation group had FPG,2hPG,HbA1c,TC,TG,LDL-C,BMI,the visceral fat index was lower than that of the control group,and the difference was statistically significant(P<0.05);after 3 months of treatment,the HDL-C levels in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).The total incidence of adverse reactions in the observation group was 13.33%,and there was no statistically significant difference compared to the total incidence of 11.11%in the control group(P>0.05).Conclusion For overweight/obese type 2 diabetes patients,the treatment of dulaglutide combined with metformin can significantly improve the glucose and lipid metabolism indexes of patients,reduce the BMI and visceral fat index index levels,and have fewer adverse reactions during treatment,which is worth promoting.