摘要
目的观察司美格鲁肽联合恩格列净与二甲双胍治疗初诊肥胖2型糖尿病(T2DM)患者的临床效果。方法选取2021年4月—2023年4月三明市第二医院内分泌科收治的初诊肥胖T2DM患者160例,按照随机数字表法分为二联药物组与三联药物组,各80例。二联药物组予二甲双胍片+恩格列净片治疗,三联药物组在二联药物组基础上给予司美格鲁肽注射液皮下注射,2组均治疗12周。比较2组临床疗效,治疗前后血糖指标[空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)]、胰岛素抵抗指数(HOMA-IR)、血糖变异性指标[葡萄糖目标范围内时间所占百分比(TIR%)、平均血糖波动幅度(MAGE)、血糖标准差(SDBG)、血糖变异系数(CVBG)],不良反应。结果三联药物组治疗总有效率为92.50%,高于二联药物组的78.75%(χ^(2)=6.144,P=0.013)。治疗12周后,2组FPG、2 hPG水平与HbA1c、HOMA-IR较治疗前均下降,且三联药物组下降幅度大于二联药物组(P<0.01);2组TIR%较治疗前升高,MAGE、SDBG、CVBG较治疗前下降,且三联药物组升高/下降幅度大于二联药物组(P<0.01)。二联药物组与三联药物组不良反应总发生率比较,差异无统计学意义(3.75%vs.6.25%,χ^(2)=0.132,P=0.717)。结论司美格鲁肽联合恩格列净与二甲双胍治疗初诊肥胖的T2DM患者临床疗效确切,可明显降低患者血糖,改善胰岛素抵抗,提高TIR%,降低血糖变异性,且安全性高。
Objective To observe the clinical efficacy of semaglutide combined with empagliflozin and metformin in the treatment of obese patients with newly diagnosed T2DM.Methods A total of 160 cases of obese patients with newly diagnosed T2DM admitted to the Department of Endocrinology of the Sanming Second Hospital from April 2021 to April 2023 were selected,and they were divided into the two drug group and the triple drug group according to the random number table method,with 80 cases in each group.The two drug group was treated with metformin tablets+empagliflozin tablets,and the triple drag group was given subcutaneous injection of semaglutide injection on the basis of the two drug group,and both groups were treated for 12 weeks.Clinical efficacy,glycemic indexes(FPG,2 hPG,HbA 1c),HOMA-IR,glycemic variability indexes(TIR%,MAGE,SDBG,CVBG)before and after treatment,and adverse reactions were compared between the two groups.Results The total effective rate of the triple drug group was 92.50%,which was higher than 78.75%of the two drug group(χ2=6.144,P=0.013).After 12 weeks of treatment,the levels of FPG and 2 hPG,HbA 1c and HOMA-IR in the two groups decreased compared with those before treatment,and the decrease in the triple drug group was greater than that in the two drug group(P<0.01).The TIR%in the two groups was higher than that before treatment,and the MAGE,SDBG,and CVBG decreased compared with those before treatment,and the increase/decrease in the triple drug group were greater than those in the two drug group(P<0.01).There was no significant difference in the total incidence of adverse reactions between the two drug group and the triple drug group(3.75%vs.6.25%,χ2=0.132,P=0.717).Conclusion Semaglutide combined with empagliflozin and metformin have an exact clinical effect in the treatment of obese patients with newly diagnosed T2DM,which can significantly reduce blood glucose,improve insulin resistance,increase the TIR%,reduce blood glucose variability,and with high safety.
作者
王艳
涂振兴
廖华萍
李烨
刘桑燕
WANG Yan;TU Zhenxing;LIAO Huaping;LI Ye;LIU Sangyan(Department of Endocrinology,Sanming Second Hospital,Fujian Province,Sanming 366000,China)
出处
《临床合理用药杂志》
2024年第27期18-21,共4页
Chinese Journal of Clinical Rational Drug Use
关键词
2型糖尿病
肥胖
初诊
司美格鲁肽
恩格列净
二甲双胍
胰岛素抵抗
血糖变异性
Type 2 diabetes mellitus
Obese
Newly diagnosed
Semaglutide
Empagliflozin
Metformin
Insulin resistance
Glycemic variability
