目的探讨甘精胰岛素联合利拉鲁肽对2型糖尿病患者血糖控制及β-细胞功能的影响。方法回顾性分析2020年2月至2021年2月就诊于我院的70例2型糖尿病患者临床资料,将35例采用利拉鲁肽治疗的患者资料纳入对照组,将35例采用甘精胰岛素联合利...目的探讨甘精胰岛素联合利拉鲁肽对2型糖尿病患者血糖控制及β-细胞功能的影响。方法回顾性分析2020年2月至2021年2月就诊于我院的70例2型糖尿病患者临床资料,将35例采用利拉鲁肽治疗的患者资料纳入对照组,将35例采用甘精胰岛素联合利拉鲁肽治疗的患者资料纳入观察组,均治疗3个月。比较两组血糖指标[空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbAlc)]、胰岛素抵抗(HOMA-IR)及β-细胞功能指数(HOMA-β),并对比两组不良反应发生情况。结果治疗3个月后,两组FPG、2 h PG、HbAlc均较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05);两组HOMA-IR较治疗前降低,HOMA-β较治疗前升高,且观察组变化较大,差异有统计学意义(P<0.05);两组不良反应发生率对比,差异无统计学意义(P>0.05)。结论2型糖尿病患者采用甘精胰岛素联合利拉鲁肽治疗可有效控制血糖,提高β-细胞功能。展开更多
AIM: To investigate the characteristics of the progression of islet β cell function in Chinese latent autoimmune diabetes in adult (LADA) patients with glutamic acid decarboxylase antibody (GAD-Ab) positivity, and to...AIM: To investigate the characteristics of the progression of islet β cell function in Chinese latent autoimmune diabetes in adult (LADA) patients with glutamic acid decarboxylase antibody (GAD-Ab) positivity, and to explore the prognostic factors for β cell function. METHODS: Forty-five LADA patients with GAD-Ab positivity screened from phenotypic type 2 diabetic (T2DM) patients and 45 T2DM patients without GAD-Ab matched as controls were followed-up every 6 mo. Sixteen patients in LADA1 and T2DM1 groups respectively have been followed-up for 6 years, while 29 patients in LADA2 and T2DM2 groups respectively for only 1.5 years. GAD-Ab was determined by radioligand assay, and C-peptides (CP) by radioimmune assay.RESULTS: The percentage of patients whose fasting CP(FCP) decreased more than 50% compared with thebaseline reached to 25.0% at 1.5th year in LADA1 group, and FCP level decreased (395.8±71.5 vs 572.8±72.3 pmol/L, P＜0.05) at 2.5th year and continuously went down to the end of follow-up. No significant changes of the above parameters were found in T2DM1 group. The average decreased percentages of FCP per year in LADA and T2DM patients were 15.8% (4.0-91.0%) and 5.2% (-3.5 to 35.5%, P= 0.000) respectively. The index of GAD-Ab was negatively correlated with the FCP in LADA patients (rs= -0.483, P = 0.000). The decreased percentage of FCP per year in LADA patients were correlated with GAD-Ab index, body mass index (BMI) and age at onset (rs = 0.408, -0.301 and -0.523 respectively, P＜0.05). Moreover, GAD-Ab wasthe only risk factor for predicting βcell failure in LADA patients (B = 1.455, EXP (B) = 4.283, P = 0.023). CONCLUSION: The decreasing rate of islet β cell function in LADA, being highly heterogeneous, is three times that of T2DM patients. The titer of GAD-Ab is an important predictor for the progression of islet β cell function, and age at onset and BMI could also act as the predictors.展开更多
文摘目的探讨甘精胰岛素联合利拉鲁肽对2型糖尿病患者血糖控制及β-细胞功能的影响。方法回顾性分析2020年2月至2021年2月就诊于我院的70例2型糖尿病患者临床资料,将35例采用利拉鲁肽治疗的患者资料纳入对照组,将35例采用甘精胰岛素联合利拉鲁肽治疗的患者资料纳入观察组,均治疗3个月。比较两组血糖指标[空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbAlc)]、胰岛素抵抗(HOMA-IR)及β-细胞功能指数(HOMA-β),并对比两组不良反应发生情况。结果治疗3个月后,两组FPG、2 h PG、HbAlc均较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05);两组HOMA-IR较治疗前降低,HOMA-β较治疗前升高,且观察组变化较大,差异有统计学意义(P<0.05);两组不良反应发生率对比,差异无统计学意义(P>0.05)。结论2型糖尿病患者采用甘精胰岛素联合利拉鲁肽治疗可有效控制血糖,提高β-细胞功能。
基金Supported by the National Natural Science Foundation of China,No. 39370343 the National Ministry of Health Youth Talents Foundation, No. Q9420 the Hunan Health Bureau Key Scientific Funds, No. 9736, 2001-Z04
文摘AIM: To investigate the characteristics of the progression of islet β cell function in Chinese latent autoimmune diabetes in adult (LADA) patients with glutamic acid decarboxylase antibody (GAD-Ab) positivity, and to explore the prognostic factors for β cell function. METHODS: Forty-five LADA patients with GAD-Ab positivity screened from phenotypic type 2 diabetic (T2DM) patients and 45 T2DM patients without GAD-Ab matched as controls were followed-up every 6 mo. Sixteen patients in LADA1 and T2DM1 groups respectively have been followed-up for 6 years, while 29 patients in LADA2 and T2DM2 groups respectively for only 1.5 years. GAD-Ab was determined by radioligand assay, and C-peptides (CP) by radioimmune assay.RESULTS: The percentage of patients whose fasting CP(FCP) decreased more than 50% compared with thebaseline reached to 25.0% at 1.5th year in LADA1 group, and FCP level decreased (395.8±71.5 vs 572.8±72.3 pmol/L, P＜0.05) at 2.5th year and continuously went down to the end of follow-up. No significant changes of the above parameters were found in T2DM1 group. The average decreased percentages of FCP per year in LADA and T2DM patients were 15.8% (4.0-91.0%) and 5.2% (-3.5 to 35.5%, P= 0.000) respectively. The index of GAD-Ab was negatively correlated with the FCP in LADA patients (rs= -0.483, P = 0.000). The decreased percentage of FCP per year in LADA patients were correlated with GAD-Ab index, body mass index (BMI) and age at onset (rs = 0.408, -0.301 and -0.523 respectively, P＜0.05). Moreover, GAD-Ab wasthe only risk factor for predicting βcell failure in LADA patients (B = 1.455, EXP (B) = 4.283, P = 0.023). CONCLUSION: The decreasing rate of islet β cell function in LADA, being highly heterogeneous, is three times that of T2DM patients. The titer of GAD-Ab is an important predictor for the progression of islet β cell function, and age at onset and BMI could also act as the predictors.
