达格列净、利拉鲁肽对超重或肥胖2型糖尿病合并冠心病患者的糖脂代谢的影响

目的 探讨达格列净、利拉鲁肽对超重或肥胖2型糖尿病合并冠心病患者的糖脂代谢的影响.方法 随机纳入2018年6月—2020年1月该院就诊的160例超重或肥胖2型糖尿病合并冠心病患者为研究对象,分两组,每组80例.所有患者均口服盐酸二甲双胍片(格华止)≥1500 mg/d,达格列净组启始予5 mg,根据血糖情况调整药物剂量...

Effects of Dapagliflozin and Liraglutide on Glucose and Lipid Metabolism in Overweight or Obese Patients with Type 2 Diabetes and Coronary Heart Disease

Objective To investigate the effects of dapagliflozin and liraglutide on glucose and lipid metabolism in overweight or obese patients with type 2 diabetes and coronary heart disease.Methods Randomly included 160 overweight or obese patients with type 2 diabetes and coronary heart disease who were treated from June 2018 to January 2020 at the hospital as the research objects,divided into two groups,each with 80 cases.All patients were given oral metformin hydrochloride tablets(Govazep)≥1500 mg/d,and the dapagliflozin group was given 5 mg at the beginning,and the dose of the drug was adjusted according to the blood glucose situation.If the fasting blood glucose>7.0 mmol/L,dapagliflozin should be increased to 10 mg,once a day.The liraglutide group was given 0.6 mg at the beginning.When the fasting blood glucose was greater than 7.0 mmol/L,the liraglutide was increased to 1.2 mg.The HbA1c,fasting blood glucose,2 h postprandial blood glucose,islet function,body mass index and adverse reactions before and after 12 weeks of treatment were compared between the two groups.Results From the perspective of improving glucose metabolism,there was no statistically significant difference in fasting blood glucose,postprandial blood glucose and glycosylated hemoglobin between the two groups of patients(P>0.05),but the body mass index of the dapagliflozin group was improved more than that of the liraglutide group,the difference was statistically significant(P<0.05).From the perspective of improving islet function,after 12 weeks of treatment,the insulin resistance index of the liraglutide group was significantly lower than that of dapagliflozin,the difference was statistically significant(P<0.05);from the perspective of safety,the incidence of adverse reactions such as hypoglycemia in the two groups was not obviously different,the difference was not statistically significant(P>0.05).Conclusion The two drugs have similar effects in treating obesity type 2 diabetes with coronary heart disease,but liraglutide has a more obvious advantage in improving insulin resistance.