| 门冬胰岛素30联合二甲双胍血糖控制不佳的2型糖尿病患者加用利拉鲁肽的临床疗效观察 |
| 投稿时间：2017-04-03 修订日期：2017-04-26 点此下载全文 |
| 引用本文：刘心苑,刘尚全,叶启宝,谈银生,田丽芳,陈望.门冬胰岛素30联合二甲双胍血糖控制不佳的2型糖尿病患者加用利拉鲁肽的临床疗效观察[J].医学研究杂志,2018,47(1):53-56,78 |
| DOI：
10.11969/j.issn.1673-548X.2018.01.014 |
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| 基金项目:国家自然科学基金资助项目（30840106） |
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| 中文摘要:目的 探讨应用门冬胰岛素30联合二甲双胍血糖控制不佳的超重或肥胖2型糖尿病患者加用利拉鲁肽的临床疗效。方法 收治符合研究标准的2型糖尿病患者60例，随机分为试验组（加用利拉鲁肽）和对照组（胰岛素加量），各30例。疗程12周，观察2组患者体重（BW）、体重指数（BMI）、空腹血糖（FPG）、餐后2h血糖（PPG）、血脂（TG、TC、LDL-C、HDL-C）、血压（BP）、糖化血红蛋白（HbA1c）、空腹C肽（FCP）、胰岛素抵抗指数（HOMA-IR）、β细胞功能指数（HOMA-β）、记录胰岛素日用总剂量，低血糖发生事件以及复合终点（HbA1c<7%+无体重增加+无低血糖的发生）达标率。结果 12周后最终57例患者完成试验。两组患者治疗前后比较，FPG、PPG、HbA1c、TG、TC、LDL-C均有下降（P<0.05），但组间比较差异无明显统计学意义（P>0.05）；试验组患者BW、BMI和日用胰岛素总量均显著下降（P<0.05），而在对照组中均增加（P<0.05）；试验组FCP、HOMA-IR降低，HOMA-β增高（P<0.05），且复合终点达标率明显高于对照组（P<0.05）。结论 对于门冬胰岛素30治疗血糖控制欠佳的2型糖尿病患者，加用利拉鲁肽与对照组相比可获得类似降糖效果，但其减重作用明显，降低了低血糖的风险，增加复合终点达标率，且改善胰岛β细胞功能。 |
| 中文关键词:2型糖尿病 门冬胰岛素30 利拉鲁肽 低血糖 临床疗效 |
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| Clinical Efficacy of Adding Liraglutide to Type 2 Diabetic Patients Poorly Controlled with Insulin Aspart 30 and Metformin |
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| Abstract:Objective To evaluate the clinical efficacy of liraglutide combined treatment in overweight or obese type 2 diabetic patients with unsatisfied glycemic control using insulin aspart 30 and metformin. Methods Sixty patients who reached certain criteria with type 2 diabetes were selected,and then were randomly divided into two groups:the experimental group (liraglutide-added group) and the control group (insulin-increasing group).Each group had 30 cases.Body weight (BW),body mass index(BMI),fasting plasma glucose (FPG),2 hour postprandial glucose (PPG),blood lipid(TG,TC,LDL-C,HDL-C),blood pressure(BP),glycosylated hemoglobin (HbA1c),fasting C-peptide(FCP),insulin resistance index (HOMA-IR),β-cell functional index (HOMA-β),daily insulin dose,all hypoglycemie events and the percentage of subjects reaching the composite endpoint(HbA1c<7% with no weight gain and no hypoglycemia) were observed and recorded in two groups. Results After 12 weeks treatment,there were 57 patients finally completed the study.FPG,PPG,HbA1c,TG,TC,LDL-C were significantly decreased following treatment in both groups(P<0.05),but were not significantly different between the two groups(P>0.05).The treatment of experimental group significantly reduced BW,BMI and daily insulin dose(P<0.05),while all of these significantly increased in the control group(P<0.05).FCP and HOMA-IR were significantly decreased.HOMA-β was increased in the experimental group (P<0.05).The percentage of subjects reaching the composite endpoint was increased in the experimental group and had significantly difference in comparision to the control group(P<0.05). Conclusion Adding liraglutide to insulin-treated patients led to improvement in glycemic control similar to that achieved by increasing insulin dosage,but with significant reduction in body weight and fewer hypoglycemic events,also improve islet β cell function. |
| keywords:Type 2 diabetes Insulin aspart 30 Liraglutide Hypoglycemia Clinical efficacy |
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