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.