利拉鲁肽治疗多种药物联用疗效不佳的肥胖2型糖尿病患者疗效观察

目的观察利拉鲁肽对多种口服降糖药物联用并和胰岛素联合治疗疗效不佳的肥胖2型糖尿病患者的临床疗效和安全性。方法选择对多种口服降糖药物联用并和胰岛素联合治疗疗效不佳的肥胖2型糖尿病患者21例,在原有治疗基础上加用利拉鲁肽治疗12周。观察比较治疗前后的空腹血糖（FBG）、餐后2 h血糖（2 hPBG）、糖化血红蛋白（HbA1c）、体重指数（BMI）、血脂、血压、空腹胰岛素（FIns）、稳态模型胰岛素抵抗指数（HOMA-IR）、稳态模型胰岛β细胞分泌指数（HOMA-β）、胰岛素使用量及不良反应等指标。结果加用利拉鲁肽治疗12周后,患者的FBG、2 hPBG、HbA1c、TG、BMI、FIns、HOMA-IR、胰岛素用量均明显下降,差异有统计学意义（P〈0.05）。治疗后的HOMA-β与治疗前比较明显升高,差异有统计学意义（P〈0.05）。主要的不良反应为胃肠道反应及低血糖,但两者均较轻微且短暂。结论对多种口服降糖药物联用且和胰岛素联合治疗后血糖仍控制欠佳的肥胖2型糖尿病患者,利拉鲁肽可有效控制血糖,改善胰岛素抵抗,提高胰岛素敏感性,增强胰岛β细胞功能。

Efficacy of liraglutide on obese type 2 diabetes patients with poor response to combinations with a variety of drugs

Objective To observe the clinical efficacy and safety of liraglutide on obese type 2 diabetes patients with resistant to combinations of oral hypoglycemic drugs and insulin. Methods Twenty one obese type 2 diabetic patients with resistant to combinations of oral hypoglycemic drugs and insulin were investigated. Liraglutide were added to the original treatment strategy for 12 weeks and its effects were observed on fasting blood glucose（FBG）, 2h postprandial blood glucose（2hPBG）, glycosylated hemoglobin（HbA1c）, body mass index（BMI）, blood lipids, blood pressure, fasting insulin（FIns）, homeostasis model assessment of insulin resistance index（HOMA-IR）, homeostasis model assessment index of pancreatic β cell secretion（HOMA-β）, insulin dosage and adverse reactions.Results The patient＇s FBG, 2hPBG, HbA1c, TG, BMI, FIns, HOMA-IR, and insulin dosage decreased significantly after 12 weeks of treatment with Liraglutide（P〈0.05）. HOMA-β increased remarkably after Liraglutide treatment（P〈0.05）. The main adverse reactions were gastrointestinal reactions and low blood sugar, both of which were mild and transient. Conclusion For obese type 2 diabetic patients with poorly controlled blood glucose even underwent combination therapy of multiple oral hypoglycemic drugs and insulin, liraglutide can effectively control blood sugar, improve insulin resistance and insulin sensitivity, and enhance islet β cells function.