达格列净对利拉鲁肽治疗后超重/肥胖2型糖尿病患者的疗效

 

目的 观察达格列净对利拉鲁肽治疗12周后超重/肥胖2型糖尿病患者(type 2 diabetic mellitus, T2DM)的疗效。方法 选取93例经利拉鲁肽治疗刚满12周的超重/肥胖T2DM患者,按1∶1随机分为利拉鲁肽(liraglutide,Lir)组46例和达格列净(dapagliflozin,Dap)组47例。Lir组继续应用利拉鲁肽,Dap组换用达格列净,继续治疗12周。比较两组治疗前后血糖、体重、腰围、血压变化。结果 治疗12周后,两组的血糖、体重、腰围、血压均较治疗前下降(P<0.01),其中空腹血糖(fasting blood glucose,FBP)(1.0±0.6)vs(0.8±0.5)] mmol/L,餐后2 h血糖(2 hours postprandial blood glucose,2hBG)(1.3±0.8)vs(1.4±0.9)]mmol/L,糖化血红蛋白(glycated hemoglobin,HbA₁c)(1.0±0.5)vs(0.9±0.6)]%,体重(1.5±1.4)vs(1.0±1.2)]kg,体重指数(body mass index,BMI)(0.7±0.6)vs(0.5±0.4)]kg/m²,收缩压(5.0±3.0)vs(5.0±2.5)]mmHg,舒张压(3.0±1.0)vs(3.0±1.2)]mmHg,下降幅度无统计学差异(P＞0.05)。但Dap组腰围下降少于Lir组(P<0.01)。结论 对利拉鲁肽治疗后超重/肥胖的T2DM患者,换用达格列净,除腰围下降较少外,降糖、减重、降压的效果与继续原药治疗相同。

Efficacy of dapagliflozin for overweight/obese patients with type 2 diabetes after liraglutide treatment

Objective To investigate the efficacy of dapagliflozin for overweight/obese patients with type 2 diabetes after 12 weeks of treatment with liraglutide.Methods A total of 93 overweight/obese type 2 diabetes patients who had been treated with liraglutide for just 12 weeks were randomly divided into the liraglutide group (n=46) and the dapagliflozin group (n=47).Patients in the liraglutide group continued to take liraglutide, while the dapagliflozin group switched to dapagliflozin. The treatment lasted 12 weeks in both groups before the changes of blood glucose, weight, waist circumference and blood pressure were compared.Results The blood glucose, weight, waist circumference and blood pressure were significantly lower in both groups after treatment(P<0.01). The extent to which fasting blood glucose (1.0±0.6)vs(0.8±0.5)] mmol/L, 2-hour postprandial blood glucose(1.3±0.8)vs(1.4±0.9)] mmol/L, glycated hemoglobin (1.0±0.5)vs(0.9±0.6)]%, body weight (1.5±1.4)vs(1.0±1.2)] kg, body mass index(0.7±0.6)vs(0.5±0.4)] kg/m², systolic blood pressure(5.0±3.0)vs(5.0±2.5)]mmHg, and diastolic blood pressure(3.0±1.0)vs(3.0±1.2)]mmHg (P>0.05) decreased was not statistically different between the two groups. However, the waist circumference of the dapagliflozin group decreased less significantly (1.9±1.3)vs(0.9±0.8)] cm(P<0.01).Conclusions For overweight/obese patients with type 2 diabetes after liraglutide treatment, switching to dapagliflozin will have the same effect as continued treatment with liraglutide on blood glucose, weight, and blood pressure except for the waist circumference.