利拉鲁肽联合胰岛素治疗肥胖或超重的2型糖尿病患者疗效观察

目的 观察胰高血糖素样肽1(GLP-1)类似物利拉鲁肽联合胰岛素治疗肥胖或超重的2型糖尿病患者临床疗效及安全性.方法 选取肥胖或超重(体质量指数≥24)的2型糖尿病患者40例,既往均使用胰岛素治疗,血糖控制不佳(糖化血红蛋白≥7.5％),随机分为两组(每组20例),A组加用利拉鲁肽,B组单纯调整胰岛素剂量.治疗12周后,观察两组空腹血糖、餐后2h血糖、糖化血红蛋白、体质量及胰岛素用量,并记录低血糖发生次数及不良反应.结果 治疗12周后,A组体质量及每天胰岛素剂量明显低于B组(t =2.738、2.865,均P＜0.01).A组发生低血糖6例次(30％),B组9例次(45％),两组差异无统计学意义(x2 =0.96,P＞0.05).结论 利拉鲁肽联合胰岛素治疗肥胖或超重的2型糖尿,可明显减少体质量及每天胰岛素剂量,不增加低血糖发生率,安全有效.

Effect of glucagon-like peptide-1 analogue combined with insulin for treating obese or overweight type 2 diabetes

Objective To observe the therapeutic efficacy and safety of the glucagon-like peptide-1 （ GLP-1 ） analogue combined with isulin for treating obese or overweight type 2 diabetes. Methods 40 cases with obese or o- verweight type 2 diabetic patients （body mass index （BMI） ≥ 24） who have previously used human insulin, and experi- enced poor glycemic control（ I〉7.5% ） were selected. They were randomly divided into two groups. A group treated by GLP-1 analogue liraglutide plus insulin, and B group by continuous adjustment of insulin. 12 weeks later,fasting blood glucose （ FBG）, 2-hour plasma glucose （ 2 hPG）, hemoglobin A1 C （ HbA 1 c ）, body weight were observed and the inci- dence of hypoglycemia,insulin dosage were recorded. Results Weight and insulin dosage of group A was significantly lower than those of group B after treatment 12 week（ t = 2.738,2.865, all P 〈 0.01 ）. Numbers of hypoglycemia events were 6 in group A（30% ） ,and 9 in group B（45% ） ,but there was no statistical significance between the two groups （P 〉 0. 05）. Conclusion The addition of liraglutide to insulin in patients with obese or overweight type 2 diabetes is associated with reductions in weight and insulin dosage, without increase risk of hypoglycemia. This treatment proved effective and safe.