利拉鲁肽联合胰岛素治疗新诊断肥胖2型糖尿病的临床疗效及安全性观察

目的 探讨利拉鲁肽联合胰岛素治疗新诊断肥胖T2DM的临床疗效及安全性. 方法 筛选新诊断肥胖T2DM患者76例,按数字随机表法分为观察组和对照组,每组各38例.对照组予胰岛素联合二甲双胍,观察组在此基础上加用利拉鲁肽.治疗16周,比较两组治疗的临床疗效及不良反应.结果 与治疗前相比,两组糖基化血红蛋白对照组：（10.94±1.55）％ vs （6.90±0.75）％;观察组：（11.41±1.43）％vs（5.86±0.76）％]、稳态模型胰岛素抵抗指数（HOMA-IR）下降对照组：（3.40±0.63）vs（2.00±0.35）;观察组：（3.38±0.66）vs（1.60±0.54）]（P均＜0.05）,而稳态模型胰岛β细胞功能指数（HOMA-β）升高（对照组：（13.34±4.07）vs（33.56±7.06）;观察组：（12.53±3.25） vs （49.88±10.58）]（P＜0.05）;观察组BMI降低（28.89±1.19） vs（26.58±0.93） kg/m2] （P＜0.01）.与对照组相比,观察组治疗后HbA1 c下降（6.90土0.75）％vs（5.86±0.76）％]、HOMA-IR （2.00±0.35）vs （1.60±0.54）] HOMA-β升高（33.56±7.06）vs（49.88±10.58）]（P＜0.05）;观察组低血糖发生率升高（72.1％vs81.6％）]（P＜0.05）.两组均无严重低血糖事件发生. 结论 利拉鲁肽联合胰岛素治疗新诊断肥胖T2DM可明显降低血糖和体重,改善胰岛β细胞功能,且无严重不良反应发生.

Efficacy and safety observation of liraglutide and insulin as combination therapy in the treatment of newly diagnosed type 2 diabetes with obesity

Objective To assess the efficacy and safety of liraglutide and insulin as combination therapy in the treatment of newly diagnosed type 2 diabetes with obesity.Methods A 16-week,randomized,parallel-group study was carried out.A total of 76 patients completed the trial who had been randomly assigned to either the liraglutide-added group （the observer group） or the group of insulin combined with metformin only（the control group）.Efficacy and adverse reactions were evaluated.Results After intervention,glycated hemoglobin A1c （HbA1 c） the control group （10.94 ± 1.55） % vs （6.90±0.75） %,the observer group （11.41±1.43）% vs （5.86±0.76）%] and insulin resistance index （HOMAIR）the control group （3.40±0.63） vs （2.00±0.35）,the observer group （3.38±0.66） vs （1.60±0.54）] decreased significantly,while homeostatic model assessment of the insulin secretion index （HOMA-β）the control group （13.34±4.07） vs （33.56±7.06）,the obser-ver group （12.53±3.25） vs （49.88±10.58）]（P〈0.05） increased significantly in all two groups（all P〈0.05）;The body mass index （BMI） decreased significantly in observer group （28.89 ± 1.19） vs （26.58 ± 0.93） kg/m2 ; The HbA1 c （6.90±0.75） % vs （5.86 ± 0.76） % and the HOMAIR （2.00 ± 0.35） vs （1.60 ± 0.54） decreased furtherin observer group when compared with the control group,while the HOMA-β was significant higher （33.56±7.06） vs （49.88±10.58） （P〈0.05）.The incidence of hypoglycemia was higher in the observer group when compared with the control group （81.6 % vs 72.1 %）（P〈0.05）.Serious hypoglycemia was not happented in two group.Conclusion The treatment of Adding liraglutide to insulin in newly diagnosed type 2 diabetes with obesity can induce a significant reduction in blood glucose and body weight; Improve function of β-cell.Serious adverse reactions were not happented.