利拉鲁肽联合胰岛素治疗新诊断肥胖2型糖尿病的临床疗效及安全性观察  

Efficacy and safety observation of liraglutide and insulin as combination therapy in the treatment of newly diagnosed type 2 diabetes with obesity

作　　者：张萍[1] 潘天荣[1] 钟兴[1] 杜益君[1] 

机构地区：[1]安徽医科大学第二附属医院内分泌科,合肥230601

出　　处：《中国糖尿病杂志》2014年第11期974-977,共4页Chinese Journal of Diabetes

基　　金：安徽省高等学校省级自然科学基金(KJ2012Z177);安徽医科大学校级科学基金(2012xkj057)

摘　　要：目的探讨利拉鲁肽联合胰岛素治疗新诊断肥胖T2DM的临床疗效及安全性。方法筛选新诊断肥胖T2DM患者76例,按数字随机表法分为观察组和对照组,每组各38例。对照组予胰岛素联合二甲双胍,观察组在此基础上加用利拉鲁肽。治疗16周,比较两组治疗的临床疗效及不良反应。结果与治疗前相比,两组糖基化血红蛋白[对照组:(10.94±1.55)%vs(6.90±0.75)%;观察组:(11.41±1.43)%vs(5.86±0.76)%]、稳态模型胰岛素抵抗指数(HOMA-IR)下降[对照组:(3.40±0.63)vs(2.00±0.35);观察组:(3.38±0.66)vs(1.60±0.54)](P均<0.05),而稳态模型胰岛β细胞功能指数(HOMA-β)升高[(对照组:(13.34±4.07)vs(33.56±7.06);观察组:(12.53±3.25)vs(49.88±10.58)](P<0.05);观察组BMI降低[(28.89±1.19)vs(26.58±0.93)kg/m2](P<0.01)。与对照组相比,观察组治疗后HbA1c下降[(6.90±0.75)%vs(5.86±0.76)%]、HOMA-IR[(2.00±0.35)vs(1.60±0.54)]HOMA-β升高[(33.56±7.06)vs(49.88±10.58)](P<0.05);观察组低血糖发生率升高[(72.1%vs 81.6%)](P<0.05)。两组均无严重低血糖事件发生。结论利拉鲁肽联合胰岛素治疗新诊断肥胖T2DM可明显降低血糖和体重,改善胰岛β细胞功能,且无严重不良反应发生。Objective To assess the efficacy and safety of liraglutide and insulin as combination therapy in the treatment of newly diagnosed type 2 diabetes with obesity.Methods A 16-week,randomized,parallel-group study was carried out.A total of 76 patients completed the trial who had been randomly assigned to either the liraglutide-added group （the observer group） or the group of insulin combined with metformin only（the control group）.Efficacy and adverse reactions were evaluated.Results After intervention,glycated hemoglobin A1c （HbA1 c） [the control group （10.94 ± 1.55） % vs （6.90±0.75） %,the observer group （11.41±1.43）% vs （5.86±0.76）%] and insulin resistance index （HOMAIR）[the control group （3.40±0.63） vs （2.00±0.35）,the observer group （3.38±0.66） vs （1.60±0.54）] decreased significantly,while homeostatic model assessment of the insulin secretion index （HOMA-β）[the control group （13.34±4.07） vs （33.56±7.06）,the obser-ver group （12.53±3.25） vs （49.88±10.58）]（P〈0.05） increased significantly in all two groups（all P〈0.05）;The body mass index （BMI） decreased significantly in observer group （28.89 ± 1.19） vs （26.58 ± 0.93） kg/m2 ; The HbA1 c （6.90±0.75） % vs （5.86 ± 0.76） % and the HOMAIR （2.00 ± 0.35） vs （1.60 ± 0.54） decreased furtherin observer group when compared with the control group,while the HOMA-β was significant higher （33.56±7.06） vs （49.88±10.58） （P〈0.05）.The incidence of hypoglycemia was higher in the observer group when compared with the control group （81.6 % vs 72.1 %）（P〈0.05）.Serious hypoglycemia was not happented in two group.Conclusion The treatment of Adding liraglutide to insulin in newly diagnosed type 2 diabetes with obesity can induce a significant reduction in blood glucose and body weight; Improve function of β-cell.Serious adverse reactions were not happented.

关 键 词：糖尿病 2型 新诊断 肥胖 利拉鲁肽 胰岛素 

分 类 号：R587.1[医药卫生—内分泌]