A Study on Enhancing Pancreatic Islet Function in Type 2 Diabetes and Coronary Heart Disease Patients with Liraglutide and Metformin Combination Therapy

Objective:To investigate the impact of combining liraglutide with metformin on the enhancement of pancreatic islet function in patients with type 2 diabetes and coronary heart disease.Methods:60 patients with type 2 diabetes and coronary heart disease admitted from February 2022 to August 2023 were selected as research subjects.They were randomly assigned to either control or treatment groups,with 30 patients in each.The control group received metformin alone,while the treatment group received liraglutide in combination with metformin.Various indicators,including blood sugar levels,pancreatic islet function,and cardiac function between the two groups were compared.Results:The results of FPG,2hPG,HbA1c,HOMA-IR,NT-proBNP,and LVEDD in the treatment group were lower than those in the control group,whereas the values of FINS,HOMA-β,E/A,and LVEF in the treatment group were higher than those in the control group(P<0.05).Conclusion:The use of liraglutide in combination with metformin significantly benefits patients with type 2 diabetes and coronary heart disease.It leads to improved pancreatic islet function,better blood sugar control,and enhanced cardiac function.This combination therapy is recommended for clinical adoption.

Effect of Renin Angiotensin System Blockade on the Islet Microvessel Density of Diabetic Rats and Its Relationship with Islet Function

To investigate the effects of rennin angiotensin system blockade on the microvessel density in islets of diabetic rats and its relationship with islet function, diabetes model was created by feeding of high-caloric laboratory chow plus intraperitoneal injection of a small dose of streptozotocin （30 mg/kg）. After 8 weeks intervention with perindopril （AE, n=10） or valsartan （AR, n=10）, the islet function of the animals was evaluated by intravenous insulin release test （IVIRT）. The pancreases were immunohistochemically stained to analyze the content of insulin and vascular endothelial growth factor （VEGF） in the islets. The microvessel density （MVD） of islets was detected by counting CD34 positive cells. The hypoxia inducible factor （HIF）-1α mRNA expression in the islets was detected by RT-PCR. Compared with normal control group （NC, n=10）, the area under the curve for insulin from 0 to 30 min （AUCI0-30） of diabetes group （DM, n=8） was decreased by 66.3%; the insulin relative concentration （IRC） of βcell was decreased significantly; the relative content of VEGF was increased obviously [（–4.21±0.13） vs （–4.06±0.29）]; MVD in islets was decreased by 71.4%; the relative expression of HIF-1α mRNA was increased by 1.19 times （all P〈0.01）. Compared with DM group, the AUCI0-30 of AE and AR group was increased by 44.6% and 34.9% respectively; IRC was also increased significantly; the relative content of VEGF was decreased by 21.2% and 21.7% respectively; MVD was increased by 62.5% and 75.0% respectively; the relative expression of HIF-1α was decreased by 27.2% and 29.0% respectively （all P〈0.01 or P〈0.05）. There were no significant differences in the said indexes between group AE and AR. It is concluded that the blockade of RAS may ameliorate islets function of diabetic rats by increasing the MVD in islets.

Influence of heme oxygenase-1 gene transfer on the viability and function of rat islets in in vitro culture

AIM: To investigate the influence of heme oxygenase-1 (HO-1) gene transfer on the viability and function of cultured rat islets in vitro. METHODS: Islets were isolated from the pancreata of Sprague-Dawley rats by intraductal collagenase diges- tion, and purified by discontinuous Ficoll density gradient centrifugation. Purified rat islets were transfected with adenoviral vectors containing human HO-1 gene (Ad- HO-1) or enhanced green fluorescent protein gene (Ad- EGFP), and then cultured for seven days. Transfection was confirmed by fluorescence microscopy and Western blot. Islet viability was evaluated by acridine orange/ propidium iodide fluorescent staining. Glucose-stimulated insulin release was detected using insulin radioimmuno- assay kits and was used to assess the function of islets. Stimulation index (SI) was calculated by dividing the insulin release upon high glucose stimulation by the insulin release upon low glucose stimulation. RESULTS: After seven days culture, the viability of cultured rat islets decreased significantly (92% ± 6% vs 52% ± 13%, P < 0.05), and glucose-stimulated insulin release also decreased significantly (6.47 ± 0.55 mIU/ L/30IEQ vs 4.57 ± 0.40 mIU/L/30IEQ, 14.93 ± 1.17 mIU/L/30IEQ vs 9.63 ± 0.71 mIU/L/30IEQ, P < 0.05). Transfection of rat islets with adenoviral vectors at an MOI of 20 was efficient, and did not impair islet function. At 7 d post-transfection, the viability of Ad-HO-1 transfected islets was higher than that of control islets(71% ± 15% vs 52% ± 13%, P < 0.05). There was no significant difference in insulin release upon low glucose stimulation (2.8 mmol/L) among Ad-HO-1 transfected group, Ad-EGFP transfected group, and control group (P > 0.05), while when stimulated by high glucose (16.7 mmol/L) solution, insulin release in Ad-HO-1 transfected group was significantly higher than that in Ad-EGFP transfected group and control group, respectively (12.50 ± 2.17 mIU/L/30IEQ vs 8.87 ± 0.65 mIU/L/30IEQ; 12.50 ± 2.17 mIU/L/30IEQ vs 9.63 ± 0.71 mIU/L/30IEQ, P < 0.05). The SI of Ad-HO-1 transfected group was also significantly higher than that of Ad-EGFP transfected group and control group, respectively (2.21 ± 0.02 vs 2.08 ± 0.05; 2.21 ± 0.02 vs 2.11 ± 0.03, P < 0.05). CONCLUSION: The viability and function of rat islets decrease over time in in vitro culture, and heme oxygenase-1 gene transfer could improve the viability and function of cultured rat islets.

Relationship between Free Thyroxine and Islet Beta-cell Function in Euthyroid Subjects

Thyroid hormones have a specific effect on glucose-induced insulin secretion from the pancreas.We aimed to investigate the association between euthyroid hormones and islet betacell function in general population and non-treated type 2 diabetes mellitus(T2DM)patients.A total of 5089 euthyroid participants(including 4601 general population and 488 non-treated T2DM patients)were identified from a cross-sectional survey on the prevalence of metabolic diseases and risk factors in East China from February 2014 to June 2016.Anthropometric indices,biochemical parameters,and thyroid hormones were measured.Compared with general population,non-treated T2DM patients exhibited higher total thyroxine(TT4)and free thyroxine(FT4)levels but lower ratio of free triiodothyronine(T3):T4(P<0.01).HOMA-βhad prominently negative correlation with FT4 and positive relationship with free T3:T4 in both groups even after adjusting for age,body mass index(BMI)and smoking.When analyzed by quartiles of FT4 or free T3:T4,there were significantly decreased trend of HOMA-β going with the higher FT4 and lower free T3:T4 in both groups.Linear regression analysis showed that FT4 but not FT3 and free T3:T4 was negatively associated with HOMA-β no matter in general population or T2DM patients,which was independent of age,BMI,smoking,hypertension and lipid profiles.FT4 is independently and negatively associated with islet beta-cell function in euthyroid subjects.Thyroid hormone even in reference range could play an important role in the function of pancreatic islets.

Small intestinal submucosa improves islet survival and function during in vitro culture

AIM: To evaluate the recovery and function of isolated rat pancreatic islets during in vitro culture with small intestinal submucosa (SIS).METHODS: Pancreatic islets were isolated from Wistar rats by standard surgical procurement followed by intraductal collagenase distension, mechanical dissociation and Euroficoll purification. Purified islets were cultured in plates coated with multilayer SIS (SIS-treated group) or without multilayer SIS (standard cultured group) for 7 and 14 d in standard islet culture media of RPMI 1640. After isolation and culture, islets from both experimental groups were stained with dithizone and counted. Recovery of islets was determined by the ratio of counts after the culture to the yield of islets immediately following islet isolation. Viability of islets after the culture was assessed by the glucose challenge test with low (2.7 mmol/L) and high glucose (16.7 mmol/L)solution supplemented with 50 mmol/L 3-isobutyl-1-methylxanthine (IBMX) solution. Apoptosis of islet cells after the culture was measured by relative quantification of histone-complexed DNA fragments using ELISA.RESULTS: After 7 or 14 d of in vitro tissue culture, the recovery of islets in SIS-treated group was significantly higher than that cultured in plates without SIS coating. The recovery of islets in SIS-treated group was about twice more than that of in the control group. In SIS-treated group, there was no significant difference in the recovery of islets between short- and long-term periods of culture (95.8±1.0% vs 90.8±1.5%, P>0.05). When incubated with high glucose (16.7 mmol/L) solution,insulin secretion in SIS-treated group showed a higher increase than that in control group after 14 d of culture (20.7±1.1 mU/L vs11.8±1.1 mU/L, P<0.05). When islets were placed in high glucose solution containing IBMX,stimulated insulin secretion was higher in SIS-treated group than in control group. Calculated stimulation index of SIS-treated group was about 23 times of control group. In addition, the stimulation index of SIS-treated group remained constant regardless of short- and long-term periods of culture (9.5±0.2 vs 10.2±1.2, P>0.05).Much less apoptosis of islet cells occurred in SIS-treated group than in control group after the culture.CONCLUSION: Co-culture of isolated rat islets with native sheet-like SIS might build an extracellular matrix for islets and provide possible biotrophic and growth factors that promote the recovery and subsequent function of islets.

EFFECTS OF GLUCAGON ON ISLET β CELL FUNCTION IN PATIENTS WITH DIABETES MELLITUS

Objective To evaluate islet β cell response to intravenous glucagon(a non-glucose secretagogue)stimulation in diabetes mellitus.Methods Nineteen patients with type 1 diabetes(T1D)and 131 patients with type 2 diabetes(T2D)were recruited in this study.T2D patients were divided into two groups according to therapy:36 cases treated with insulin and 95 cases treated with diet or oral therapy.The serum C-peptide levels were determined at fasting and six minutes after intravenous injection of 1 mg of glucagon.Results Both fasting and 6-minute post-glucagon-stimulated C-peptide levels in T1D patients were significantly lower than those of T2D patients(0.76±0.36 ng/mL vs.1.81±0.78 ng/mL,P<0.05;0.88±0.42 ng/mL vs.3.68±0.98 ng/mL,P<0.05).In T1D patients,the C-peptide level after injection of glucagon was similar to the fasting level.In T2D,patients treated with diet or oral drug had a significantly greater fasting and stimulated C-peptide level than those patients received insulin therapy(2.45±0.93 ng/mL vs.1.61±0.68 ng/mL,P<0.05;5.26±1.24 ng/mL vs.2.15±0.76 ng/mL,P<0.05).The serum C-peptide level after glucagon stimulation was positively correlated with C-peptide levels at fasting in all three groups(r=0.76,P<0.05).Conclusions The 6-minute glucagon test is valuable in assessing the function of islet β cell in patients with diabetes mellitus.It is helpful for diagnosis and treatment of diabetes mellitus.

Islet cell transplantation as a cure for insulin dependent diabetes: current improvements in preserving islet cell mass and function

OBJECTIVE: To review the current progress of islet cell transplantation in patients with insulin-dependent diabetes, emphasizing on the difficulties with recovering and preserving islet cell mass and function, 30% of which is lost during the peri-transplantation period. RESULTS: The islet-cell isolation technique is perfected, but improvements are still progressing in two major directions: preservation of islet cells and tolerance induction. Optimum islet cell viability and function depends on appropriate revascularization of the islet graft and blockade of thrombus formation as well as cytokine and free radical release. Conditioning the islet cells in-vitro prior to transplantation to either upregulate VEGF expression or downregulate NF-kappa B transcription factor has proven to improve revascularization and to prevent islet cell apoptosis and cytokine-mediated damage. Tolerance induction is currently being best achieved by selecting and combining immunosuppressive agents such as monoclonal antibodies which target the major signaling molecules during immune activation, but which are least toxic to islet cells. CONCLUSIONS: Patients with insulin-dependent diabetes will greatly benefit from current developments in effective approaches to protect islets during the peritransplant period. Emerging interest in stem cell biology and differentiation may provide the ultimate solution to the problem of organ scarcity and islet cell protection from the peritransplant induced damage.

玉液汤加减联合二甲双胍和德谷门冬双胰岛素对2型糖尿病气阴两虚证患者临床疗效观察

目的:对玉液汤加减联合二甲双胍和德谷门冬双胰岛素对2型糖尿病(T2DM)气阴两虚证患者的临床疗效进行探讨。方法:将60例T2DM患者随机分为对照组(n=30)和观察组(n=30),对照组采用二甲双胍联合德谷门冬双胰岛素治疗,观察组在此基础上应用玉液汤加减治疗,比较2组治疗后的中医证候积分、糖化血红蛋白(Hb Alc)、空腹血糖(FPG)、餐后2 h血糖(2h PG)、日内平均血糖波动幅度(MAGE)、胰岛素抵抗指数(HOMA-IR)和胰岛素分泌指数(HOMA-IS)。结果:治疗后,观察组总有效率显著高于对照组(93.33%vs 86.67%);观察组中医证候积分、Hb Alc、FPG、2h PG、MAGE和HOMA-IR等指标均低于对照组,HOMA-IS高于对照组(均P<0.05)。结论:玉液汤加减联合二甲双胍和德谷门冬双胰岛素对2型糖尿病气阴两虚证患者疗效显著,可有效控制患者的血糖并改善胰岛功能。

达格列净联合阿托伐他汀治疗糖尿病肾病的效果及对患者胰岛功能和机体微炎症状态的影响

目的探究达格列净联合阿托伐他汀治疗糖尿病肾病(DN)的效果及对患者胰岛功能和机体微炎症状态的影响。方法选取2021年2月至2022年2月海南省海口市人民医院收治的DN患者116例,按随机数字表法分为对照组和观察组,各58例。对照组采用阿托伐他汀钙片治疗,观察组在对照组基础上联合达格列净片治疗,2组均治疗3个月。比较治疗总有效率,治疗前后肾功能、胰岛功能指标和炎症因子水平。结果观察组总有效率显著高于对照组[93.1%(54/58)比77.6%(45/58)],差异有统计学意义(χ^(2)=5.583,P=0.018)。治疗后2组血尿素氮、血肌酐、24 h尿蛋白定量均明显低于治疗前,且观察组均低于对照组,差异均有统计学意义(均P<0.001)。治疗后2组稳态模型胰岛素抵抗指数均显著低于治疗前且观察组低于对照组[(2.43±0.28)比(2.67±0.31)],稳态模型胰岛β细胞功能指数均显著高于治疗前且观察组高于对照组[(13.4±3.8)比(10.5±3.3)],差异均有统计学意义(均P<0.05)。治疗后2组白细胞介素6、肿瘤坏死因子α、高敏C反应蛋白水平均显著低于治疗前且观察组低于对照组,差异均有统计学意义(均P<0.05)。结论达格列净联合阿托伐他汀治疗DN临床效果较好,可以有效改善患者胰岛功能,减轻机体的微炎症状态。

2型糖尿病伴桥本甲状腺炎患者甲状腺抗体滴度与胰岛功能的相关性研究

目的 探究2型糖尿病(T2DM)伴甲状腺功能正常的桥本甲状腺炎(HT)患者的甲状腺特异性抗体滴度与胰岛功能的相关性。方法 选择2021年1月至2023年5月于安徽医科大学附属安庆市立医院内分泌科就诊的92例甲状腺功能正常的HT伴T2DM患者,根据C肽水平将其分为低C肽水平组(50例)和高C肽水平组(42例)。比较两组性别、年龄、糖尿病病程、糖化血红蛋白(Hb A1c)、体重指数(BMI)、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)、25羟维生素D[25(OH)D]等指标。采用二元logistic回归模型分析胰岛功能的独立危险因素。结果 两组TPOAb、TGAb、糖尿病病程、25(OH)D、Hb A1c、BMI比较,差异有统计学意义(P<0.05)。二元logistic回归分析结果显示,TPOAb(OR=1.005,95%CI:1.001~1.009)、TGAb(OR=1.007,95%CI:1.000~1.014)、糖尿病病程(OR=1.455,95%CI:1.118~1.895)、BMI(OR=0.693,95%CI:0.517~0.928)、25(OH)D(OR=0.848,95%CI:0.726~0.991)是胰岛功能的影响因素(P<0.05)。结论 在T2DM合并HT患者中,TPOAb、TGAb的滴度水平与胰岛功能损伤有关,甲状腺自身免疫性抗体滴度是胰岛功能衰竭的独立危险因素。

甘精胰岛素U300联合口服降糖药治疗2型糖尿病的临床效果观察

目的探讨甘精胰岛素U300联合口服降糖药治疗2型糖尿病的临床效果。方法选择2021年10月—2023年1月广东省吴川市人民医院收治的79例2型糖尿病患者,随机分为非甘精组(39例)和U300组(40例)。非甘精组口服降糖药物治疗,在此之上,U300组增加甘精胰岛素U300治疗,持续治疗3个月,对比2组血糖及相关指标变化,并监测患者胰岛素功能相关指标改善情况,评估低血糖反应等不良反应情况。结果治疗后,U300组血糖指标、血糖波动指标均显著低于非甘精组,差异有统计学意义(P<0.05)。U300组治疗后胰岛素功能指标均显著优于非甘精组,空腹及餐后2 h C肽均显著高于非甘精组,差异有统计学意义(P<0.05)。U300组低血糖反应发生率(2.50%,1/40)和不良反应总发生率(20.00%,8/40)与非甘精组(2.56,1/39;17.95%,7/39)比较,差异无统计学意义(P>0.05)。结论增加甘精胰岛素U300治疗,可更好地提升患者血糖管理效果,并可改善胰岛功能,有利于稳定控制血糖,有助于提高患者病情控制效果,应用效果安全可靠。

有氧运动联合抗阻运动对妊娠期糖尿病患者胰岛细胞功能及糖脂代谢的影响

目的:探究有氧运动联合抗阻运动对妊娠期糖尿病患者胰岛细胞功能及糖脂代谢的影响。方法:将2021年5月—2023年6月松滋市人民医院的100例妊娠期糖尿病患者依据随机数字表法分为对照组50例和观察组50例。对照组进行常规妊娠期糖尿病干预,观察组则在对照组的基础上加用有氧运动联合抗阻运动。比较两组的干预总有效率、干预前后的胰岛细胞功能[稳态模型评估胰岛素抵抗指数(HOMA-IR)及稳态模型评估β细胞功能指数(HOMA-β)]、糖代谢指标[空腹血糖(FPG)、餐后2 h血糖(2 h PG)及糖化血红蛋白(HbA1c)]及脂代谢指标[总胆固醇(TC)、三酰甘油(TG)及低密度脂蛋白胆固醇(LDL-C)]。结果:观察组的干预总有效率高于对照组(P<0.05)。干预前两组的胰岛细胞功能、糖代谢指标及脂代谢指标比较,差异均无统计学意义(P>0.05),干预4、8周后,两组的HOMA-β均高于干预前,且观察组均高于对照组,两组的HOMA-IR、糖代谢指标及脂代谢指标均低于干预前,且观察组均低于对照组(P<0.05)。结论:有氧运动联合抗阻运动在妊娠期糖尿病患者中的应用效果较好,且可显著改善患者的胰岛细胞功能及糖脂代谢状态。

卡格列净联合洛塞那肽对2型糖尿病胰岛素抵抗患者胰岛功能、YKL-40、PPARγ的影响

目的研究卡格列净联合洛塞那肽对2型糖尿病胰岛素抵抗患者疗效,及对胰岛功能、血清YKL-40、过氧化物酶体增殖物激活受体γ(PPARγ)的影响。方法选择2型糖尿病患者98例,随机均分为对照组(洛塞那肽治疗)和联合组(卡格列净联合洛塞那肽治疗),比较两组临床疗效、胰岛功能、血清YKL-40、PPARγ水平、血糖指标及不良反应发生率。结果联合组治疗总有效率高于对照组(P<0.05)。两组不良反应总发生率比较差异无显著性(P>0.05)。与治疗前比较,两组治疗后胰岛素曲线下面积、胰岛β细胞功能指数、PPARγ升高,胰岛素抵抗指数、YKL-40、空腹血糖、2 h餐后血糖、糖化血红蛋白、体质指数降低;且联合组变化更为显著(P<0.05)。结论卡格列净联合洛塞那肽治疗可有效提高2型糖尿病胰岛素抵抗患者胰岛功能,并显著改善YKL-40、PPARγ水平。

25羟维生素D3及T淋巴细胞亚群变化与成人隐匿性自身免疫性糖尿病患者胰岛功能的关系

目的:观察不同滴度谷氨酸脱羧酶抗体(GADA)成人隐匿性自身免疫性糖尿病(LADA)患者25羟维生素D3[25(OH)D3]水平及T淋巴细胞亚群的变化,探讨其与胰岛β细胞功能的关系。方法:在成人糖尿病(DM)患者中筛查获得GADA阳性患者,根据GADA滴度水平分为低滴度组和高滴度组,对照组为普通2型糖尿病(T2DM)患者。检测空腹血糖(FBG)、血脂、肝肾功能,糖化血红蛋白(HbA1c)、空腹血清C肽(FCP)、25(OH)D3和T淋巴细胞亚群(CD3^(+)、CD4^(+)和CD8^(+))。计算胰岛素抵抗指数[Homa-IR(CP)]和胰岛功能指数[Homa-islet(CP)]。结果:与T2DM组比较,高滴度组体重指数(BMI)、25(OH)D3水平、FCP、餐后2 h C肽(2 hCP)、Homa-IR(CP)和Homa-islet(CP)均降低,差异有统计学意义(P<0.05),同时合并有较低的总胆固醇(TC)、三酰甘油(TG)、尿酸(UA)水平,差异有统计学意义(P<0.05);低滴度组也表现出BMI、25(OH)D3水平、FCP、2 hCP、Homa-IR(CP)和Homa-islet(CP)降低,伴低TC水平,差异有统计学意义(P<0.05)。高滴度组CD4^(+)/CD8^(+)T比值高于低滴度组,差异有统计学意义(P<0.05),LADA患者CD4^(+)/CD8^(+)比值与GADA滴度呈正相关(r=0.37,P<0.01),25(OH)D3水平与Homa-islet(CP)呈正相关(r=0.32,P=0.02)。结论:低25(OH)D3水平及T淋巴细胞亚群比例失衡与胰岛β细胞功能损伤有关并参与LADA病程的进展。

刍议2型糖尿病治疗中度拉糖肽使用的有效性与安全性

目的刍议2型糖尿病治疗中度拉糖肽使用的有效性与安全性。方法随机选取2021年2月—2023年2月莱州市人民医院内分泌科收治的80例2型糖尿病患者为研究对象,遵循随机双盲法分为对照组和观察组,各40例。对照组采用二甲双胍治疗,观察组采用二甲双胍联合度拉糖肽治疗。比较两组治疗有效性与安全性相关指标。结果治疗后,两组血糖指标均明显降低,且观察组空腹血糖(Fasting Plasma Glucose,FPG)、餐后2 h血糖(2-hour Postprandial Blood Glucose,2 hPG)、糖化血红蛋白(Glycated Hemoglobin,HbA1c)低于对照组,差异有统计学意义(P均<0.05)。治疗后,两组稳态模型胰岛素抵抗指数(Homeostatic Model Assessment for Insulin Resistance,HOMA-IR)、稳态模型胰岛β细胞分泌指数(Homeostatic Model Assessment for Insulinofβ-cell,HOMA-β)均得到改善,且观察组HOMA-IR更低、HOMA-β更高,差异有统计学意义(P均<0.05)。对于,观察组不良反应发生率为10.00%与对照组的15.00%比较,差异无统计学意义(χ^(2)=0.457,P>0.05)。结论2型糖尿病治疗中度拉糖肽的使用有利于更好地调控患者的血糖水平与胰岛功能,且不会增加不良反应,可以为患者预后质量与安全性提供保障。

西格列他钠联合德谷门冬双胰岛素治疗2型糖尿病的临床研究

目的探讨西格列他钠联合德谷门冬双胰岛素治疗2型糖尿病的临床疗效。方法选取2022年8月—2023年5月威海第970医院内分泌科收治的应用口服降糖药或预混人胰岛素治疗效果不佳的84例2型糖尿病患者为研究对象,以随机数表法分为研究组(n=42)、对照组(n=42),两组均给予常规治疗措施,对照组采用德谷门冬双胰岛素治疗,研究组在对照组基础上联合西格列他钠治疗。比较两组糖化血红蛋白(Glycosyl-ated Hemoglobin A1c,HbA1c)、空腹血糖(Fasting Plasma Glucose,FPG)、餐后2 h血糖(2-hours Postprandial Plasma Glucose,2 hPG)、胰岛素的用量、空腹胰岛素(Fasting Insulin,FINS)、胰岛素抵抗指数(Homeostatic Model Assessment-Insulin Resistance,HOMA-IR)、胰岛β细胞功能指数(Homeostasis Model Assessment-β,HOMA-β)、体重指数(Body Mass Index,BMI)及低血糖发生情况。结果治疗12周后,研究组HbA1c、FPG、2 hPG、胰岛素用量、HOMA-IR水平低于对照组,而FINS、HOMA-β水平高于对照组,差异有统计学意义(P均<0.05);两组体重指数、低血糖发生情况比较,差异无统计学意义(P均>0.05)。结论德谷门冬双胰岛素联合西格列他钠对2型糖尿病患者疗效显著,能有效控制其血糖水平;西格列他钠可有效改善患者胰岛功能,减轻胰岛素抵抗,减少胰岛素用量,未增加体重指数及低血糖发生率。

双相门冬胰岛素治疗2型糖尿病对血糖水平的影响评估分析

目的探析双相门冬胰岛素治疗2型糖尿病对血糖水平的影响。方法方便选取2022年4月—2023年6月三峡大学第一临床医学院收治的78例2型糖尿病患为研究对象。按照入院治疗先后顺序将所有研究对象分成参照组(39例)、观察组(39例)。参照组予以口服降糖药物治疗,观察组予以双相门冬胰岛素治疗。对两组疗效、血糖水平、胰岛功能进行对比。结果观察组临床治疗总有效率(97.44%)高于参照组(79.49%),差异有统计学意义(χ^(2)=6.154,P<0.05)。治疗后,两组空腹血糖、餐后2 h血糖、糖化血红蛋白等血糖指标均降低,且观察组低于参照组,差异有统计学意义(P均<0.05)。治疗后,两组胰岛素抵抗指数均降低,且观察组低于参照组;两组胰岛β细胞功能指数均升高,且观察组高于参照组,差异有统计学意义(P均<0.05)。结论2型糖尿病治疗时采取双相门冬胰岛素辅助治疗相比单一口服降糖药物效果更佳,可更有效降低患者血糖水平、改善患者胰岛功能。

利拉鲁肽联合甘精胰岛素治疗对2型糖尿病合并肥胖患者体质指数、血糖及胰岛功能的影响

目的探讨将利拉鲁肽、甘精胰岛素相结合作为2型糖尿病(Type 2 Diabetes Mellitus,T2DM)伴肥胖者治疗方案对患者体质指数(Body Mass Index,BMI)、血糖、胰岛功能影响。方法选取2022年1月—2023年10月宝应县中医医院收治的80例T2DM伴肥胖患者为研究对象,采取随机分组法分为观察组和对照组,各40例。对照组以单纯甘精胰岛素进行治疗,观察组以利拉鲁肽联合甘精胰岛素进行治疗。两组患者均干预3个月,比较干预前后两组BMI、血糖指标[空腹血糖(Fasting Blood Glucose,FPG)、餐后2 h血糖(2 h Postpran-dial Blood Glucose,2 hPG)、糖化血红蛋白(Glycosylated Hemoglobin,HbA1c)]、胰岛功能[胰岛素抵抗指数(Homeostasis Model Assessment of Insulin Resistance Inde,HOMA-IR)]变化。结果干预前,对比两组BMI、血糖及HOMA-IR指标,差异无统计学意义(P均>0.05);干预3个月观察组患者BMI(23.15±1.25)kg/m^(2)、FPG(6.02±0.84)mmol/L、2 hPG(7.25±1.12)mmol/L、HbA1c(4.85±0.62)%、HOMA-IR(3.42±0.52)都明显比对照组低,差异有统计学意义(P均<0.05)。结论T2DM伴肥胖者的治疗,采用利拉鲁肽、甘精胰岛素协同方式干预,可以取得满意的干预效果,明显降低BMI,有利于血糖控制以及调节胰岛功能指标。

探究2型糖尿病患者采用双胍类降糖药物的治疗效果

目的探究2型糖尿病应用双胍类降糖药物的疗效。方法选取2023年1—12月滕州市妇幼保健院收治的80例2型糖尿病为研究对象,根据随机数表法分为对照组和观察组,各40例。对照组口服瑞格列奈片,观察组口服双胍类降糖药物二甲双胍片,持续用药8周后,对比两组血糖、胰岛功能及不良反应。结果两组治疗前的血糖及胰岛功能比较,差异无统计学意义(P均>0.05);治疗4、8周后,观察组的血糖及胰岛功能更优于对照组,差异有统计学意义(P均<0.05)。观察组不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论2型糖尿病患者应用双胍类降糖药物二甲双胍片治疗,可改善血糖与胰岛功能,可减少不良反应。

二甲双胍联合阿卡波糖治疗2型糖尿病的疗效及对糖脂代谢的影响

目的 观察二甲双胍联合阿卡波糖治疗2型糖尿病的疗效及对糖脂代谢的影响。方法 选取2020年2月—2021年2月湘潭市第二人民医院收治的2型糖尿病患者70例为研究对象,按电脑随机法将患者分为阿卡波糖组(n=35)与联合治疗组(n=35)。阿卡波糖组予阿卡波糖,联合治疗组予二甲双胍联合阿卡波糖,2组均持续治疗3个月。比较2组临床疗效,治疗前后氧化应激指标[血清超氧化物歧化酶(SOD)、丙二醛(MDA)]、糖脂代谢指标[糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2 hPG)、总胆固醇(TC)、三酰甘油(TG)]、胰岛功能指标[空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)],不良反应。结果 联合治疗组总有效率高于阿卡波糖组(97.14%vs. 77.14%,χ^(2)=4.590,P=0.032)。治疗3个月后,2组血清SOD水平高于治疗前,血清MDA水平低于治疗前,且联合治疗组高/低于阿卡波糖组(P<0.01);2组HbA1c和FPG、2 hPG、TC、TG水平、HOMA-IR低于治疗前,FINS高于治疗前,且联合治疗组低/高于阿卡波糖组(P<0.01)。联合治疗组与阿卡波糖组不良反应总发生率比较,差异无统计学意义(11.43%vs. 5.71%,χ^(2)=0.182,P=0.669)。结论 二甲双胍联合阿卡波糖治疗2型糖尿病的疗效确切,可有效降低血糖、血脂和氧化应激反应,且联合治疗并未增加不良反应发生风险。