摘要
目的 探究利拉鲁肽联合地特胰岛素治疗二甲双胍控制不佳的肥胖2型糖尿病患者的疗效。方法 80例二甲双胍控制不佳的肥胖2型糖尿病患者,均采用利拉鲁肽联合地特胰岛素治疗。对比患者治疗前后生化指标[体质量指数(BMI)、体质量、空腹血糖(FPG)、餐后2 h血糖(2 h PG)、空腹C肽(FCP)、餐后2 h C肽(2 h CP)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)、谷草转氨酶(AST)、空腹胰岛素(FINS)、餐后2 h胰岛素(2 h INS)]。结果 治疗后,患者BMI(29.14±2.10)kg/m2、体质量(85.31±1.13)kg、FPG(6.31±1.28)mmol/L、2 h PG(10.21±1.39)mmol/L、HbA1c(7.16±1.10)%、TG(2.85±0.61)mmol/L、TC(4.98±1.03)mmol/L、LDL-C(2.74±0.19)mmol/L、HOMA-IR(1.28±0.41)、AST(22.13±8.51)U/L均低于治疗前的(30.41±2.51)kg/m2、(87.52±1.84)kg、(10.52±2.62)mmol/L、(15.61±4.85)mmol/L、(8.61±1.29)%、(3.61±0.29)mmol/L、(5.61±1.29)mmol/L、(3.72±0.29)mmol/L、(1.49±0.61)、(25.41±10.26)U/L, FCP(3.61±2.30)ng/ml、2 h CP(13.25±3.25)ng/ml、HDL-C(1.46±0.39)mmol/L、HOMA-β(4.10±0.89)、FINS(85.63±10.32)pmol/L、2 h INS(102.30±10.62)pmol/L高于治疗前的(2.81±1.64)ng/ml、(6.31±2.28)ng/ml、(1.02±0.14)mmol/L、(3.52±0.75)、(65.61±10.29)pmol/L、(80.56±10.82)pmol/L,差异均有统计学意义(P<0.05)。结论 利拉鲁肽与地特胰岛素联合应用治疗二甲双胍控制不佳肥胖2型糖尿病的临床疗效确切,可有效改善血糖、血脂水平,在降低肥胖患者BMI的同时无明显低血糖情况发生,此治疗方案可供临床采纳。
Objective To investigate the efficacy of liraglutide combined with insulin detemir in the treatment of obese patients with type 2 diabetes mellitus poorly controlled by metformin.Methods 80 obese patients with type 2 diabetes melitus poorly controlled by metformin were treated with liraglutide combined with insulin detemir.Biochemical indicators[body mass index(BMI),body weight,fasting plasma glucose(FPG),2 h postprandial glucose(2 h PG),fasting C peptide(FCP),postprandial 2 h C peptide(2 h CP),glycosylated hemoglobin(HbA1c),triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),homeostasis model assessment insulin resistance index(HOMA-IR),homeostasis model assessment pancreatic-βcells function(HOMA-β),aspartate aminotransferase(AST),fasting insulin(FINS),2-h postprandial insulin(2 h INS)]before and after treatment were compared.Results After treatment,the BMI was(29.14±2.10)kg/m2,body weight was(85.31±1.13)kg,FPG was(6.31±1.28)mmol/L,2 h PG was(10.21±1.39)mmol/L,HbA1c was(7.16±1.10)%,TG was(2.85±0.61)mmol/L,TC was(4.98±1.03)mmol/L,LDL-C was(2.74±0.19)mmol/L,HOMA-IR was(1.28±0.41),AST was(22.13±8.51)U/L,which were lower than(30.41±2.51)kg/m2,(87.52±1.84)kg,(10.52±2.62)mmol/L,(15.61±4.85)mmol/L,(8.61±1.29)%,(3.61±0.29)mmol/L,(5.61±1.29)mmol/L,(3.72±0.29)mmol/L,(1.49±0.61),(25.41±10.26)U/L before treatment;the FCP was(3.61±2.30)ng/ml,2 h CP was(13.25±3.25)ng/ml,HDL-C was(1.46±0.39)mmol/L,HOMA-βwas(4.10±0.89),FINS was(85.63±10.32)pmol/L,2 h INS was(102.30±10.62)pmol/L,which were higher than(2.81±1.64)ng/ml,(6.31±2.28)ng/ml,(1.02±0.14)mmol/L,(3.52±0.75),(65.61±10.29)pmol/L,(80.56±10.82)pmol/L before treatment;all the differences were statistically significant(P<0.05).Conclusion Liraglutide combined with insulin detemir has definite clinical efficacy in the treatment of obese patients with type 2 diabetes mellitus poorly controlled by metformin,which can effectively improve the blood glucose and blood lipid levels,reduce the BMI of obese patients at the same time without the occurrence of significant hypoglycemia.This treatment scheme can be adopted in clinic.
作者
王璇
WANG Xuan(Tieling Central Hospital,Tieling 112000,China)
出处
《中国实用医药》
2022年第13期120-122,共3页
China Practical Medicine
