不同胰高糖素样肽-1受体激动剂在中国2型糖尿病患者达到治疗目标的短期成本分析

目的 本研究评价一年的时间内,在中国医疗保健体系内使用不同胰高糖素样肽-1受体激动剂（GLP-1RA）对中国2型糖尿病患者实现HbA1c治疗目标和减重的相对成本。方法 使用SUSTAIN3、SUSTAIN7和SUSTAIN10的研究结果,分析达到血糖控制、不增加体重和低血糖发生结果相关的单终点和复合终点的患者比例。根据患者比例计算达到临床治疗目标所需要的人数、年成本和相对成本。计算成本依据患者使用药物的年度成本,以2022年中国医保定价RMB(CN)表示。结果 司美格鲁肽更有效地使患者达到每个终点和复合终点,达到临床治疗目标所需要的人数（NNT）更少。达到HbA1c <7%目标艾塞那肽缓释剂、度拉糖肽、利拉鲁肽控制成本分别是司美格鲁肽的4.77,1.64,2.53倍;而达到HbA1c <7%无低血糖和体重增加目标分别是司美格鲁肽的6.27,1.74,2.89倍。结论 在中国治疗2型糖尿病患者方面,与艾塞那肽缓释剂、度拉糖肽、利拉鲁肽相比,司美格鲁肽具有更好的性价比。     

利拉鲁肽治疗2型糖尿病的疗效和药物经济学的研究进展

目的对利拉鲁肽治疗2型糖尿病的临床疗效和安全性及其药物经济学的研究进展进行综述,为临床合理应用利拉鲁肽提供参考依据。方法查阅国内外利拉鲁肽治疗2型糖尿病的期刊文献,进行归纳总结。结果利拉鲁肽能有效降低血糖和糖化血红蛋白水平,控制血糖波动范围和变异幅度,明显改善和促进胰岛β细胞功能的恢复,降低胰岛素抵抗,显著降低体质量,具有良好的安全性,成本效果优势较佳。结论利拉鲁肽具有良好的临床疗效和药物经济学效益,是治疗2型糖尿病成本与效果兼优的个体化方案。     

司美格鲁肽和度拉糖肽的控制成本分析

目的:采取中国卫生体系视角，计算40周治疗期间司美格鲁肽和度拉糖肽达到治疗目标的控制成本。方法:达到与血糖控制、体质量、低血糖结局相关的单一和复合终点的患者比例(数据)来自SUSTAIN7研究。成本测算包括药品费用、针头和不良反应成本。控制成本的计算方法是将每位患者使用每种药物的总成本，以2 022元人民币(CNY)表示，除以达到每个临床治疗终点的患者比例。结果:每周一次皮下注射0.5 mg司美格鲁肽(0.5 mg/周司美格鲁肽)在使患者达到治疗目标上更有效，且在各临床终点下显示出更低的控制成本。对于每名患者达到三联复合终点的成本，0.5 mg/周司美格鲁肽为7 321.3元，1.5 mg/周度拉糖肽为10 477.4元，1.5 mg/周度拉糖肽较司美格鲁肽高出43.1%。对于HbA1c≤6.5%、HbA1c<7%、HbA1c降低≥1.0%且体质量减轻≥3.0%、体质量减轻≥5%、体质量减轻≥10%而言，使用1.5 mg/周度拉糖肽相较使用0.5 mg/周司美格鲁肽的成本分别增加35.2%、31.6%、96.4%、90.2%和127.0%。结论:对于中国2型糖尿病患者的治疗而言，...     

胰高血糖素样肽-1类似物利拉鲁肽治疗2型糖尿病的机制与临床评价

目的:介绍胰高血糖素样肽-1类似物利拉鲁肽治疗2型糖尿病的机制与临床评价。方法:查阅相关文献,并对其进行分析归纳、总结。结果与结论:利拉鲁肽能迅速、高效地降低血糖和糖化血红蛋白(HbA1c)水平,保护胰岛B细胞功能,降低患者体重。利拉鲁肽治疗发生低血糖的概率非常低,是治疗2型糖尿病的新选择。     

利拉鲁肽治疗超重的2型糖尿病24例临床观察

目的观察胰高糖素样激动剂1（GLP-1）的类似物利拉鲁肽治疗超重或肥胖的2型糖尿病的有效性及安全性。方法选择于2011—01—12～2013—01—20在本院接受治疗的超重2型糖尿病患者24例,所有患者在二甲双胍及吡咯列酮治疗的基础上加用利拉鲁肽,最初1周给予患者利拉鲁肽0．6mg晚上睡前皮下注射,第2周加量至1．6mg。观察患者的临床疗效,每2周随访1次,观察治疗12周后患者的FPG、2h-PPG、HbAlc、体重、收缩压及舒张压水平变化和不良反应情况。结果治疗12周后患者的FPG、2h-PPG、HbAIc、体重、收缩压及舒张压与治疗前比较,均有明显的改善,差异有统计学意义（P〈0．05）。无严重的不良反应。结论利拉鲁肽治疗超重或肥胖的2型糖尿病疗效肯定,安全,不增加体重,无明显不良反应的另一类糖尿病合适选择的治疗方法。     

糖尿病治疗新药——利拉鲁肽

目的:介绍治疗糖尿病新药利拉鲁肽。方法:根据文献,对利拉鲁肽的作用机制、药动学、临床疗效、不良反应等方面信息进行综述与评价。结果:利拉鲁肽通过胰高血糖素样肽-1受体调节体内血糖水平;皮下注射后体内半衰期达10h以上,与部分药物之间存在药动学相互作用;可显著降低糖化血红蛋白水平,具有降低体重和改善β细胞功能的作用;不良反应主要包括胃肠道反应和免疫原性反应等。结论:利拉鲁肽每日1次注射具有延缓糖尿病进展和减少心血管并发症发生的潜力。     

利拉鲁肽血药浓度变化对2型糖尿病合并动脉粥样硬化患者的临床影响评价

目的：探究2型糖尿病合并动脉粥样硬化患者血药利拉鲁肽浓度与其不良反应相关性,确定最佳利拉鲁肽血药浓度。方法：选取2018年2月至2019年2月在巴中市中心医院接受利拉鲁肽药物治疗的80例2型糖尿病合并动脉粥样硬化患者为研究对象。患者均在用药过程中检测利拉鲁肽血药浓度;治疗时间1年,根据血糖临床控制疗效标准确定显效、有效及无效组。分别统计各组患者治疗前、治疗后12个月不良反应及相关因子指标;ROC曲线分析降低患者不良反应的最佳血药利拉鲁肽的浓度。结果：HPLC检测利拉鲁肽血药浓度色谱图基线平稳,回归方程线性良好;显效患者42例,有效患者25例,无效患者13例,3组患者中位利拉鲁肽谷浓度分别为116.40,102.58,82.33 ng·mL^-1,显效组中位利拉鲁肽谷浓度最高,有效组次之,无效组最后,各组之间差异有统计学意义（P<0.05）。利拉鲁肽分成A组（<100 ng·mL^-1）、B组（100~120 ng·mL^-1）、C组（120~140 ng·mL^-1）及D组（>140 ng·mL^-1）4个浓度区间;当高于120 ng·mL^-1时,易发生低血糖症,差异有统计学意义（P<0.05）。利拉鲁肽血药浓度对FPG、PBG、HbA1c、TC、TG、LDL-C、ALT、Cr、AIP、IMT厚度、sICAM-1、sVCAM-1及颈动脉粥样硬化面积影响性大,差异有统计学意义（P<0.05）。ROC曲线分析利拉鲁肽最佳浓度为108.44 ng·mL^-1,差异有统计学意义（P<0.05）。结论：适度调整糖尿病合并动脉粥样硬化患者血液中利拉鲁肽浓度可以降低药物不良反应,提高临床疗效。     

利拉鲁肽联合二甲双胍治疗2型糖尿病合并冠心病的临床观察

目的:观察利拉鲁肽联合二甲双胍治疗2型糖尿病合并冠心病的疗效和安全性。方法:选取我院内分泌科和心血管内科的2型糖尿病合并冠心病患者60例,随机均分为观察组和对照组。对照组患者给予利拉鲁肽,每日1次、皮下注射,起始剂量1.2mg,视情况逐渐加量至1.8 mg并维持。观察组患者给予利拉鲁肽,每日1次、皮下注射,剂量1.2 mg;并每日2次服用二甲双胍,起始剂量500 mg,逐渐加量直至血糖水平达标。观察患者治疗前及治疗24周后的餐后2 h血糖(2 h PG)、糖化血红蛋白(Hb A1c)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、收缩压(SBP)、舒张压(DBP)、体质量指数(BMI)、C反应蛋白(CRP)、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)及舒张早期/舒张晚期二尖瓣血流速度的比值(E/A),并记录用药期间的不良反应发生情况。结果:治疗前,两组患者各指标比较差异均无统计学意义(P>0.05);治疗24周后,两组患者BMI、TG、TC、LDL-C、SBP、DBP、CRP、2 h PG、Hb A1c和LVEDD均较治疗前显著下降,LVEF和E/A则较治疗前显著上升,且观察组TG、TC、LDL-C、CRP、LVEDD、LVEF和E/A的改善程度均显著优于对照组,差异有统计学意义(P<0.05)。观察组患者一过性厌食及恶心呕吐的发生率显著低于对照组(P<0.05)。结论:利拉鲁肽联合二甲双胍治疗2型糖尿病合并冠心病比单用利拉鲁肽能更有效地降低患者心血管危险因素的风险,且安全性也相对更好。     

利拉鲁肽治疗2型糖尿病合并肥胖患者对胰岛素抵抗的影响

目的观察利拉鲁肽及胰岛素治疗2型糖尿病合并肥胖患者对胰岛素抵抗的影响。方法将本研究中70例2型糖尿病合并肥胖患者随机分为试验组和对照组各35例,试验组在利拉鲁肽治疗下和对照组在胰岛素治疗下,通过增加利拉鲁肽的使用量及胰岛素的使用量使两组患者在1个月内血糖控制达标,继续治疗6个月时为观察点1(即治疗6个月时),停试验组利拉鲁肽治疗,若患者血糖仍高,仍继续利拉鲁肽治疗,对照组持续胰岛素治疗1年后为观察终点(即治疗1.5年时)。对比治疗6个月时、1.5年后两组患者胰岛素抵抗的差异。观察指标有:HOMA-IR、HOMA-β、FINS、FBG、2h PG、Hb A1C、BMI、TG、LDL-C。结果试验组在治疗6个月后、1.5年后HOMA-IR水平较治疗前下降(P<0.05)。对照组在治疗6个月后、1.5年后HOMA-IR水平较治疗前无统计学意义(P>0.05)。试验组在治疗6个月后、1.5年后HOMA-IR水平差值较对照组变化显著(P<0.05)。结论利拉鲁肽治疗2型糖尿病合并肥胖患者对胰岛素抵抗减轻明显,减轻体重,改善BMI、血糖、血脂,不发生低血糖风险。     

利拉鲁肽联合二甲双胍治疗2型糖尿病的临床观察

目的探讨利拉鲁肽联合二甲双胍治疗2型糖尿病的效果。方法回顾分析2011年6月至2012年6月期间在我科住院治疗的2型糖尿病患者80例的临床资料。在继续服用入院前药物（二甲双胍）的前提下,加用利拉鲁肽注射液1次/d晨起皮下注射,疗程8周。治疗后观察疗效。结果患者体重减轻,2 hPBG、FBG、HbA1 c、C肽等明显下降,不良反应症状均较轻,能耐受,在1周之内症状缓解,发生低血糖3例,症状轻,适当降低用药剂量,未产生严重后果。结论利拉鲁肽联合二甲双胍治疗2型糖尿病作用显著,能减轻体重,不良反应少,低血糖风险小,值得广大学者做进一步的研究。     

利拉鲁肽和西格列汀在治疗2型糖尿病中的长期益处对比

目的：比较利拉鲁肽和西格列汀在治疗中国2型糖尿病（T2DM）患者中的长期临床和成本益处。方法：数据来源于一项随机对照试验（NCT02008682）,2型糖尿病患者随机分为注射利拉鲁肽1.2 mg·d^-1和口服西格列汀100 mg·d^-1。根据已发表和验证的CORE糖尿病模型,对临床结果和直接费用进行长期预测。未来成本和临床结果的贴现率为每年0%和5%。并进行敏感性分析。结果：与西格列汀相比,使用利拉鲁肽的预期寿命（14.12年 vs. 13.89年）和健康调整生命年[9.11 vs. 8.91（QALYs）]延长,并通过有效控制血糖,减少了肾病、心血管疾病、眼科、糖尿病足等相关并发症的发生。利拉鲁肽1.2 mg比西他列汀的增量成本效益比增加了72 101元/QALY。敏感性分析结果表明,使用利拉鲁肽的QALY和治疗成本均高于西格列汀,并且改善的血糖控制可能是临床获益的主要影响因素。结论：利拉鲁肽加入二甲双胍单药治疗可以改善健康调整生命年,是治疗T2DM的一种经济有效的方法。     

Liraglutide: a review of its use in the management of type 2 diabetes mellitus

Liraglutide (Victoza?) is a subcutaneously administered glucagon-like peptide-1 (GLP-1) receptor agonist produced by recombinant DNA technology and used as an adjunct to diet and exercise in the treatment of adults with type 2 diabetes mellitus. This article reviews the clinical efficacy and tolerability of liraglutide in adults with type 2 diabetes, and provides a summary of its pharmacological properties. Recently published pharmacoeconomic studies of liraglutide are also reviewed. Administered subcutaneously, liraglutide (usually 1.2 or 1.8?mg once daily) generally produced greater improvements in glycaemic control than active comparators or placebo when administered as monotherapy or in combination with one or two oral antidiabetic drugs (OADs) to adults with type 2 diabetes in numerous randomized, controlled phase III trials. These included six trials in the LEAD trial programme that was designed to evaluate the efficacy and safety of liraglutide across a continuum of antihyperglycaemic management for patients with type 2 diabetes. Liraglutide was generally well tolerated, with a low risk of hypoglycaemia evident, in the phase III trials. The most common adverse events were gastrointestinal and included nausea and diarrhoea; most events were mild to moderate in severity and decreased in incidence over time. In conclusion, liraglutide has an important place in the management of adults with type 2 diabetes across a continuum of care. As well as providing effective glycaemic control, liraglutide improves pancreatic β-cell function and leads to bodyweight loss, thereby addressing some of the unmet needs of patients treated with traditional OADs.     

Is liraglutide or exenatide better in type 2 diabetes?

Background: Subjects with type 2 diabetes have high circulating levels of glucose. Glucagon-like peptide-1 (GLP-1) is an intestinal hormone that has a major role in glucose homeostasis. Exenatide and liraglutide are both agonists at the GLP-1 receptor, and are effective at reducing circulating glucose levels (measured as Hb_A1c levels), but they have not been compared. Objectives/methods: This evaluation is of a clinical trial comparing liraglutide once a day with exenatide twice a day in subjects with type 2 diabetes. Results: In the Liraglutide Effect and Action in Diabetes (LEAD)-6 trial, subcutaneous liraglutide 1.8 mg once a day was compared with exenatide 10 μg twice a day. The primary efficacy outcome was change in Hb_A1c levels, and this was significantly greater with liraglutide (1.12%) than with exenatide (0.79%). Liraglutide and exenatide had similar small abilities to reduce body weight, blood pressure and LDL-cholesterol. Conclusions: Liraglutide was more effective than exenatide for overall glycaemic control in subjects with type 2 diabetes. However, this is only true for the preparations and doses tested, that is liraglutide 1.8 mg once weekly and exenatide 10 μg b.i.d., and may not apply when the comparison is undertaken with the new longer-lasting preparation of exenatide once weekly.     

The pharmacokinetics, pharmacodynamics, and tolerability of liraglutide, a once-daily human GLP-1 analogue, after multiple subcutaneous administration in healthy Chinese male subjects

In this single-center, randomized, double-blind, within dose group, placebo-controlled, dose escalation trial, the pharmacokinetics, pharmacodynamics, tolerability, and safety of liraglutide were evaluated in 37 healthy Chinese subjects. Subjects were randomized to 1 of 3 dose groups (0.6, 1.2, or 1.8 mg), and within each group, randomized to liraglutide or placebo (3:1). All subjects started at 0.6 mg liraglutide (or placebo) once daily for 1 week, and the dose was increased for dose groups 1.2 mg and 1.8 mg in weekly steps of 0.6 mg to the predefined dose targets. Liraglutide or placebo was administered once daily by subcutaneous injection for 21 consecutive days. The dose relationships of AUC(0-24h), C(max), and C(trough) at steady state do not deviate in a relevant way from dose proportionality. t(max) and t(1/2) were 8 hours (median) and 11.2 to 12.2 hours (geometric mean), respectively. The plasma glucose levels in all liraglutide groups were decreased, while reduced serum insulin level was observed in the 1.2- and 1.8-mg groups after liraglutide treatment. The most common adverse events were of gastrointestinal origin. Other adverse events were comparable between the liraglutide and placebo groups. Liraglutide was well tolerated in healthy Chinese subjects. No major safety concerns were identified.     

利拉鲁肽治疗2型糖尿病疗效分析

目的：评价利拉鲁肽治疗2型糖尿病（T2DM）的疗效及安全性。方法纳入门诊经口服降糖药物末达到理想血糖控制标准的2型糖尿病患者48例,随机分为对照组和试验组,每组24例,在继续服用口服降糖药物的基础上,试验组注射利拉鲁肽,对照组注射门冬胰岛素30注射液,血糖达标值设定为：空腹血糖（FPG）＜7 mmol/L,餐后2 h血糖（2hPPG）＜10 mmol/L,血糖达标后调整原有治疗药物用量,疗程16周。对两组患者FPG、2hPPG、糖化血红蛋白（HbA1c）、BMI、低血糖发生次数进行自身及组间对比。结果两组患者治疗16周后FPG、2hPPG、HbA1c均较治疗前明显下降（P＜0.05）,两组间比较差异无统计学意义（P＞0.05）,而全天血糖标准差（0.75±0.13 vs.1.30±0.25,P＜0.05）、最大血糖波动幅度（2.08±0.46 vs.3.83±0.63,P＜0.05）、餐后血糖波动幅度（0.79±0.25 vs.1.65±0.42,P＜0.05）、空腹血糖变异系数（0.12±0.02 vs.0.20±0.05,P＜0.05）和日间血糖平均绝对差（0.51±0.12 vs.1.28±0.31,P＜0.05）指标试验组显著低于对照组。试验组治疗16周后的BMI明显小于治疗前（P＜0.05）,试验组发生症状性低血糖及夜间低血糖次数都明显少于对照组（P＜0.05）,对照组治疗前后BMI差异比较无统计学意义（P＞0.05）。结论与门冬胰岛素30相比,利拉鲁肽可有效控制血糖,同时减少血糖的波动性,减少低血糖发生次数,并能明显降低BMI。     

利拉鲁肽和门冬胰岛素30对肥胖2型糖尿病患者疗效和β细胞功能影响的比较

目的比较利拉鲁肽和门冬胰岛素30分别与二甲双胍联合对肥胖2型糖尿病患者的疗效和β细胞功能的影响。方法将65例新诊断以及口服降糖药物效果欠佳的肥胖2型糖尿病患者,分为利拉鲁肽组[利拉鲁肽联合二甲双胍（n=30）]和门冬胰岛素30组[门冬胰岛素30联合二甲双胍治疗（n=35）],均治疗12周。分别测定所有对象治疗前后的体重（BW）、体重指数（BMI）、空腹血糖（FPG）、餐后2 h血糖（PPG）、糖化血红蛋白（Hb A1c）、糖化白蛋白（GA）、血清总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白-胆固醇（LDL-C）、高密度脂蛋白-胆固醇（HDL-C）、血清空腹C肽（FCP）、餐后2 h C肽（PCP）等指标,并计算β细胞功能指数（HOMA-β）和胰岛素抵抗指数（HOMA-IR）。比较各组治疗前后及两组间各项指标变化情况。结果利拉鲁肽组治疗12周后BW及BMI均较治疗前下降（P〈0.01）,与门冬胰岛素30组相比差异具有统计学意义（P〈0.01）。两组治疗后FPG、PPG、Hb A1c和GA均较治疗前下降（P〈0.01）。利拉鲁肽组治疗后FCP、PCP和HOMA-IR较治疗前下降（P〈0.05）,HOMA-β上升（P〈0.01）;而门冬胰岛素30组治疗后FCP和PCP较治疗前上升（P〈0.05）,HOMA-β上升（P〈0.01）。两组治疗后HOMA-IR下降差异具有统计学意义（P〈0.05）。利拉鲁肽组治疗后TC、TG及LDL-C较治疗前下降（P〈0.05）;而门冬胰岛素30组治疗后TC和LDL-C较治疗前下降（P〈0.05）。结论利拉鲁肽或门冬胰岛素30联合二甲双胍治疗对肥胖2型糖尿病患者的血糖指标控制均有效,并均可改善其β细胞功能。但在控制体重及改善胰岛素抵抗方面,利拉鲁肽更优于门冬胰岛素30。     

Fixed-ratio combination therapy with GLP-1 receptor agonist liraglutide and insulin degludec in people with type 2 diabetes

Introduction: A fixed combination of basal insulin degludec and glucagon-like peptide-1 receptor agonist (GLP-1RA) liraglutide (IDegLira; 50 units degludec/1.8 mg liraglutide) has been developed as a once daily injection for the treatment of type 2 diabetes (T2D). In the phase 3a trial programme ‘Dual action of liraglutide and insulin degludec in type 2 diabetes’ (DUAL?), five trials of 26 weeks duration and one trial of 32 weeks duration have evaluated the efficacy and safety of IDegLira compared with administration of insulin degludec, insulin glargine, liraglutide alone or placebo.

Areas covered: Combination therapy with IDegLira reduces HbA1c more than monotherapy with a GLP-1RA (liraglutide) or insulin (degludec or glargine). Combination therapy leads also to weight loss, or a stable body weight, with no increase in hypoglycaemia. Rates of adverse events did not differ between treatment groups; however, gastrointestinal side effects were fewer with IDegLira compared with liraglutide treatment alone. A limitation of the DUAL? development programme is that patients receiving basal insulin doses in excess of 50 units were excluded from the studies.

Expert commentary: In conclusion, IDegLira combines the clinical advantages of basal insulin and GLP-1RA treatment, and is a treatment strategy that could improve the management of patients with T2D.     

Liraglutide reduces the body weight and waist circumference in Chinese overweight and obese type 2 diabetic patients

Aim:

To investigate the effects of liraglutide, a glucagon-like peptide-1 (GLP-1) receptor activator, on body weight and waist circumference in Chinese overweight and obese type 2 diabetic patients.

Methods:

A total of 328 Chinese overweight and obese type 2 diabetic patients were included in this multi-center, open-labeled and self-controlled clinical study. The patients were subcutaneously injected with liraglutide once daily for 24 weeks as add-on therapy to their previous hypoglycemic treatments. Statistical analyses were performed using SPSS software package version 11.5 for Windows.

Results:

Liraglutide treatment caused significant reduction of the mean body weight (from 86.61±14.09 to 79.10±13.55 kg) and waist circumference (from 101.81±13.96 to 94.29±14.17 cm), resulting in body weight lose of 5%–10% in 43.67% patients, and body weight loss above 10% in 34.06% patients, who had significant lower plasma creatinine levels. Baseline waist circumference, BMI and HOMA-IR were independently correlated with the body weight loss. Furthermore, liraglutide treatment significantly decreased HbA1c levels (from 8.66%±2.17% to 6.92%±0.95%) with HbA1c<7.0% in 35.37% patients, who had a significantly lower baseline level of HbA1c, but higher baseline levels of C peptide and glucagon. Moreover, liraglutide treatment resulted in greater body weight loss in patients with a long duration of diabetes, and better glycemic control in patients with a short duration of diabetes.

Conclusion:

Liraglutide significantly reduces body weight and waist circumference in Chinese overweight and obese type 2 diabetic patients. Patients with apparent visceral obesity, insulin resistance and a long duration of diabetes may have greater body weight loss; whereas patients with high insulin-secreting ability, hyperglucagonemia, and short-duration diabetes may obtain better glycemic control with liraglutide.     

利拉鲁肽治疗肥胖2型糖尿病患者临床观察

目的应用利拉鲁肽治疗肥胖T2DM患者,观察有效性及安全性。方法应用二甲双胍或二甲双胍＋胰岛素血糖仍控制不佳的肥胖T2DM患者,加用利拉鲁肽0．6～1．2mg／d,观察3个月,比较治疗前后FPG、2hPG、HBAlC-、BMI、C肽的变化。观察并记录不良反应。结果治疗后患者上述指标均比治疗前有所下降,C肽水平有所恢复,对比差异有统计学意义（P〈0．01）,应用胰岛素的患者胰岛素用量均有不同程度减少,部分患者停用胰岛素。部分患者出现一过性恶心症状。无严重低血糖发生。结论胰岛功能轻度受损的肥胖T2DM患者应用利拉鲁肽治疗不仅可以良好的控制血糖、减少血糖的波动、减少胰岛素用量,而且能够改善患者BMI。