利拉鲁肽联合胰岛素短期强化治疗新诊断超重/肥胖2型糖尿病患者临床疗效的研究  

Clinical efficacy of Liraglutide combined with short?term insulin in newly diagnosed overweight/obese patients with type 2 diabetes mellitus

作　　者：吴方来[1] 黄大祥[1] 杨秀峰 李清 张宗兰 潘艳丽 倪黎 任红霞 WU Fanglai;HUANG Daxiang;YANG Xiufeng(Department of Endocrinology,Anqing Municipal Hospital,Anqing 246003,China)

机构地区：[1]安庆市立医院内分泌科,246003

出　　处：《中国糖尿病杂志》2024年第12期912-917,共6页Chinese Journal of Diabetes

基　　金：安庆市科技计划项目(2022Z206)。

摘　　要：目的探讨利拉鲁肽联合Ins短期强化治疗在新诊断超重/肥胖T2DM患者中的临床疗效。方法选取2022年11月至2023年10月于安庆市立医院内分泌科住院治疗的新诊断超重/肥胖T2DM患者144例,随机分为强化治疗(Int)和利拉鲁肽(Lir)组,各72例。Int组采用二甲双胍片口服联合三餐前门冬胰岛素、睡前甘精胰岛素皮下注射治疗,Lir组在Int组基础上加用利拉鲁肽皮下注射治疗。比较两组治疗前后1、4、12周BP、体重、BMI、WC、WHR、血糖、血脂、血尿酸(SUA)、胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)、血糖达标时间、Ins用量及注射次数、停用餐时Ins及低血糖发生例数等。结果治疗4、12周后Lir组BP、体重、BMI、WC、WHR低于治疗前(P<0.05)。治疗1、4、12周后Lir组2 hPG低于Int组(P<0.05),治疗12周后Hb A1c低于Int组[(6.49±0.41)%vs(8.31±0.75)%,P<0.05]。治疗4、12周后,Lir组HDL-C、1 hC-P、HOMA-β高于Int组,TC、TG、LDL-C、SUA、HOMA-IR低于Int组(P<0.05)。Lir组血糖达标时间小于Int组[(4.23±1.55)vs(6.23±1.78)d,P<0.05],治疗4、12周后Lir组基础胰岛素用量低于治疗前及Int组,治疗1、4、12周后餐时Ins用量、Ins皮下注射次数、低血糖发生率低于Int组,停用餐时Ins例数高于Int组(P<0.05)。结论新诊断超重/肥胖T2DM患者在Ins强化治疗的基础上联用利拉鲁肽,有利于控制BP、体重、BMI、WC、WHR、血糖、SUA,保护胰岛β细胞功能,缩短血糖达标时间,减少Ins用量及注射次数,降低低血糖风险。Objective To investigate the clinical efficacy of Liraglutide(Lir)combined with short-term insulin intensive therapy in newly diagnosed overweight/obese patients with type 2 diabetes mellitus(T2DM).Methods A total of 144 newly diagnosed overweight/obese patients with T2DM admitted to the Endocrinology Department of Anqing Municipal Hospital from November 2022 to October 2023 were enrolled and randomly divided into intensive treatment(Int)group and Lir group with 72 cases in each group.The intensive Int group received oral Metformin tablets combined with subcutaneous injections of insulin before meals and insulin glargine before bedtime.The Lir group received subcutaneous injections of Liraglutide in addition to the Int group.The changes in blood pressure(BP),weight,BMI,WC,WHR,blood glucose(BG),blood lipids,SUA,HOMA-IR,HOMA-β,BG target time,insulin dosage and injection frequency,number of cases of meal-time insulin discontinuation and incidence of hypoglycemia before and after 1,4,and 12 weeks of treatment were evaluated and compared between the two groups.Results After 4 and 12 weeks of treatment,the BP,weight,BMI,WC and WHR were significantly lower than before treatment in the Lir group(P<0.05).2 h PG at 1,4 and 12 weeks after treatment was significantly lower in Lir group than in Int group(P<0.05),and HbA1c after 12 weeks of treatment were significantly lower in Lir group than in Int group[(6.49±0.41)%vs(8.31±0.75)%,P<0.05].After 4and 12 weeks of treatment,HDL-C,1 hC-P and HOMA-βwere significantly higher in Lir group than in Int group,while TC,TG,LDL-C,SUA and HOMA-IR was significantly lower in Lir group than in Int group(P<0.05).The time for BG to reach the standard was significantly shorter in Lir group than in Int group[(4.23±1.55)vs(6.23±1.78)d,P<0.05].After treatment for 4 and 12 weeks,the basal insulin dosage decreased significantly.After treatment for 1,4,and 12 weeks,the insulin dosage during meals,the number of subcutaneous insulin injections,and the incidence of hypoglycemia were significantly r

关 键 词：利拉鲁肽 短期胰岛素强化治疗 糖尿病 2型 超重 肥胖 

分 类 号：R587.1[医药卫生—内分泌]