胰岛素治疗超重或肥胖2型糖尿病患者加用利拉鲁肽的临床疗效观察  

Efficacy and safety of liraglutide as add-on therapy to regular insulin in overweight or obese patients with type 2 diabetes

作　　者：李意[1] 赵蕾[2] 祝开思[2] 赵丹威[2] 李丽[2] 王彤[2] 曲建昌[2] 张丽萍[2] 

机构地区：[1]南方医科大学研究生学院,广州510515 [2]解放军第305医院内分泌科

出　　处：《中国糖尿病杂志》2015年第3期241-244,共4页Chinese Journal of Diabetes

摘　　要：目的观察经胰岛素治疗但血糖控制不佳的超重或肥胖T2DM患者加用利拉鲁肽的疗效及安全性。方法选取经胰岛素治疗但血糖控制不佳的超重或肥胖T2DM患者62例,分为利拉鲁肽治疗组30例和胰岛素治疗组32例。利拉鲁肽组在加用利拉鲁肽时,胰岛素剂量暂减30%,后根据血糖水平调整胰岛素和利拉鲁肽剂量。胰岛素组根据血糖水平调整胰岛素剂量。检测两组治疗前后体重、FPG、HbA1c、FC-P和胰岛素日用量等指标,记录低血糖发生情况及其他不良反应。结果利拉鲁肽组和胰岛素组体重、FC-P和胰岛素日用量差值比较差异有统计学意义[(4.7±6.4)vs(1.0±2.1)kg;(0.80±0.30)vs(0.16±0.08)ng/ml;(25.9±12.7)vs(12.1±5.7)U/d,P<0.05或P<0.01],FPG、HbA1c差值比较差异无统计学意义[(2.5±1.1)vs(2.9±1.6)mmol/L;(1.8±1.2)%vs(1.7±1.3)%,P>0.05]。结论对超重或肥胖T2DM患者,胰岛素联合利拉鲁肽与胰岛素加量降糖疗效相当,但利拉鲁肽可降低体重,改善胰岛细胞功能。Objective To explore the efficacy and safety of insulin treatment alone versus in combination of insulin with liraglutide in overweight or obese T2DM patients. Methods A total of 62 overweight or obese T2DM patients with unsatisfactory glycemic control under insulin treatment were enrolled in this study. 30 patients were assigned to liraglutide as add-on therapy to insulin and 32 patients were still in insulin treatment alone. Insulin dose was reduced by 30% upon the initiation of liraglutide, and then the dose of liraglutide and insulin were adiusted according to blood glucose subsequently. Insulin group also received dose titration on the basis of blood glucose. Weight, FPG, HbA1 c, FC-P, insulin daily dose and other parameters were measured at baseline and 12 weeks after treatment. The hypoglycemic events and other adverse events were also recorded. Results After treatment, weight loss was observed in the liraglutide group （4.7±6.4）kg while weight gain was seen in insulin group （1.0±2.1）kg （P〈 0. 05）. The difference in FPG and HbA1 c reduction were not significant in liraglutide group versus insulin group： the FPG reduction （2.5 ±1.1） vs （2.9 ±1.6） mmo/L, respectively （P〉 0.05） and HbAlc reduction （1.8 ± 1.2 ） % vs （ 1.7 ±1.3 ）%, respectively （ P 〉 0.05 ） . The increment of FC-P was significantly higher in liraglutide group than in insulin group. Insulin daily dosage was reduced by （25.9±12.7）U/d in liraglutide group while increased （12.1±5.7）U/d in insulin group （P〈0.01）. Conclusion In overweight and obese T2DM patients, treatment with liraglutide plus insulin leads to greater improvement in weight, islet {unction and similar improvements in glycaemic control as compared with insulin treatment alone.

关 键 词：糖尿病 2型 超重 肥胖 胰岛素 利拉鲁肽 

分 类 号：R587.1[医药卫生—内分泌]