摘要
目的观察德谷胰岛素与利拉鲁肽联合治疗难治性2型糖尿病的有效性与安全性。方法选取2021年1—12月空军军医大学西京九八六医院内分泌科收治难治性2型糖尿病患者66例,按1∶1以随机数字表法分配为对照组和试验组,各33例。对照组采用甘精胰岛素联合门冬胰岛素治疗,试验组采用德谷胰岛素联合利拉鲁肽治疗,均治疗12周。比较2组治疗前后空腹血糖(FPG)、糖化血红蛋白(HbA_(1c))、空腹血清C肽(FCP)、餐后2小时血清C肽(2 hPCP)、胰岛素抵抗指数(HOMA-IR)、体质量指数(BMI)水平,以及基础胰岛素全天使用量、药物使用依从性、不良反应发生率、低血糖发生率。结果治疗12周后,2组FPG、HbA_(1c)水平均较治疗前降低(P均<0.001),但组间比较差异无统计学意义(P>0.05);试验组FCP、2 hPCP均高于对照组,HOMA-IR水平低于对照组(t=4.702、18.390、6.305,P均<0.001);试验组BMI、基础胰岛素全天使用量低于对照组,注射药物使用依从性高于对照组(t/P=2.988/0.004、6.674/<0.001、2.786/0.007);试验组低血糖发生率低于对照组(χ^(2)=4.243,P=0.039),2组不良反应发生率比较差异无统计学意义(P>0.05)。结论德谷胰岛素与利拉鲁肽联合治疗对难治性2型糖尿病患者的血糖控制、血糖稳定、胰岛素抵抗改善、胰腺功能的恢复均有良好的效果。
Objective To observe the efficacy and safety of insulin degludec combined with liraglutide in the treatment of refractory type 2 diabetes.Methods A total of 66 patients with refractory type 2 diabetes who were admitted to the Endocrinology Department of Xijing 986 Hospital,Air Force Military Medical University from January to December 2021 were selected and assigned to the control group and the experimental group according to the 1:1 random number expression,with 33 cases in each group.The control group was treated with insulin glargine combined with insulin aspart,and the experimental group was treated with insulin degludec combined with liraglutide for 12 weeks.The fasting blood glucose(FPG),glycosylated hemoglobin(HbA_(1c)),fasting serum C-peptide(FCP),2-hour postprandial serum C-peptide(2 hPCP),insulin resistance index(HOMA-IR)and body mass index(BMI)were compared between the two groups before and after treatment,as well as the daily dosage of basal insulin,drug compliance,incidence of adverse reactions,and incidence of hypoglycemia.Results After 12 weeks of treatment,the levels of FPG and HbA_(1c) in the two groups were lower than those before treatment(P<0.001),but there was no significant difference between the two groups(P>0.05);FCP and 2 hPCP in the experimental group were higher than those in the control group,and HOMA-IR levels were lower than those in the control group(t=4.702,18.390,6.305,P<0.001);The BMI and dosage of insulin in the experimental group was lower than that in the control group,but the compliance of drug injection was higer than that in the control group(t/P=2.988/0.004,6.674/<0.001,2.786/0.007);The incidence of hypoglycemia in the experimental group was lower than that in the control group(χ^(2)=4.243,P=0.039).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Insulin degludec combined with liraglutide has good effects on blood sugar control,blood sugar stability,improvement of insulin resistance,and recovery of pancreatic function in patients with refractory type 2 diabetes.
作者
李洁
叶欣
刘晓宇
谢柏梅
邵英
刘立栋
毛培军
Li Jie;Ye Xin;Liu Xiaoyu;Xie Baimei;Shao Ying;Liu Lidong;Mao Peijun(Department of Endocrinology, Air Force No.986 Hospital, Air Force Military Medical University, Shannxi Province,Xi’an 710054, China)
出处
《疑难病杂志》
CAS
2022年第5期470-474,共5页
Chinese Journal of Difficult and Complicated Cases
基金
陕西省自然科学基础研究计划一般项目(面上2019JM-422)
陕西省卫生健康科研基金项目(2018D089)。
关键词
2型糖尿病
难治性
德谷胰岛素
利拉鲁肽
疗效
Type 2 diabetes mellitus,refractory
Degludec
Liraglutide
Therapeutic effect
