应用动态血糖监测系统评价利拉鲁肽对初诊2型糖尿病患者的疗效及安全性

应用动态血糖监测系统评价人胰高糖素样肽1（GLP-1）类似物利拉鲁肽与中性鱼精蛋白锌胰岛素（NPH）分别联合二甲双胍对初诊2型糖尿病（T2DM）患者的疗效和安全性.63例初诊T2DM患者按随机数字表法随机分为利拉鲁肽联合二甲双胍组（利拉鲁肽组,31例）和NPH联合二甲双胍组（NPH组,32例）,治疗12周.研究对象在接受治疗前和治疗12周后行72 h动态血糖监测（CGMS）,比较治疗前后两组血糖波动情况、血脂及体质指数（BMI）等的变化.计量资料比较采用t检验,计数资料比较用x2检验.12周治疗后,两组的空腹血糖（FPG）、糖化血红蛋白（HbA1c）、平均血糖（MBG）均较基线明显下降,两组间差异无统计学意义（P＞0.05）;利拉鲁肽组平均血糖波动幅度（MAGE）、血糖波动最大幅度（LAGE）、日间血糖平均绝对差（MODD）、平均餐后血糖漂移幅度（MPPGE）、夜间（20：00至次日6：00）血糖≤3.0 mmol/L时间百分比（TPG≤3.0 mmol/L）、BMI、甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、收缩压（SBP）低于NPH组（t=2.773、3.250、2.870、2.721、4.955、2.686、2.152、2.310、2.342、2.048,P均＜0.05）,利拉鲁肽组低血糖发生率低于NPH组（x2＝4.14,P＜0.05）.研究表明利拉鲁肽与NPH联合二甲双胍均能有效控制初诊T2DM患者血糖,而利拉鲁肽能够明显减少血糖波动,低血糖发生率更低,同时降低体重、收缩压、血脂.

Evaluation of efficacy and safety of liraglutide in newly diagnosed type 2 diabetic patients with continuous glucose monitoring system

To evaluate the efficacy and safety of liraglutide and neutral protamine hagedorn （NPH） in combination with metformin in newly diagnosed type 2 diabetic patients with continuous glucose monitoring system （CGMS）.A total of 63 newly diagnosed type 2 diabetic patients were randomized into the liraglutide plus metformin group and NPH plus metformin group.They were treated for 12 weeks.Continuous glucose monitoring （CGM） was performed for 72 hours in both groups before and after treatment.The parameters of blood glucose fluctuations,blood lipid and BMI were measured and compared before and after treatment.Fasting plasma glucose （FBG）,glycated hemoglobin A 1c （HbA1c） and mean blood glucose （MBG） were decreased in both groups after 12 weeks treatment,but there was no statistical difference in the comparison between the two groups （P〉0.05）.In the liraglutide group,the mean average glucose excursions （MAGE）,large amplitude of glycemia excursion （LAGE）,mean of daily differences （MODD）,mean postprandial glucose excursion （MPPGE）,TPG≤3.0 mmol/L,body mass index （BMI）,triglyceride （TG）,total cholesterol （TC）,low density lipoprotein-cholesterol （LDL-C） and systolic blood pressure （SBP） were significantly lower than those in the NPH group respectively（t=2.773,3.250,2.870,2.721,4.955,2.686,2.152,2.310,2.342,2.048,P〈0.05,respectively）.The incidence of hypoglycemia episode in the liraglutide group was significantly lower than in the NPH group （x2=4.14,P〈0.05）.Both groups have a good control of blood glucose for newly diagnosed type 2 diabetic patients.As compared with NPH,liraglutide can reduce the glucose fluctuation and have less hypoglycemia event,while liraglutide is superior in weight reduction,improvement of blood lipid and blood pressure.