摘要
目的探讨达格列净联合利拉鲁肽治疗及基础-餐时胰岛素治疗对新诊断超重的2型糖尿病患者的疗效及安全性.方法选取2019年1月至2020年6月在本院内分泌科住院的超重的2型糖尿病患者125例,按照随机数字表法将患者随机分为达格列净联合利拉鲁肽组(观察组)及基础-餐时胰岛素组(对照组).对照组三餐前及睡前分别注射门冬胰岛素和甘精胰岛素,共观察8周.评估两组患者治疗后血糖达标时间及FPG、2 hPG、HbAlc、体重、血压、血脂自基线的变化和不良事件.结果观察组和对照组血糖达标时间分别为(6.5±1.8)d、(5.9±1.7)d,差异无统计学意义.治疗后两组FPG、2 hPG、HbA1c、TG、TC、LDL-C均显著下降,HDL-C高于基线水平,差异均有统计学意义(P<0.01).而观察组治疗后体重、收缩压、舒张压、血尿酸、UACR均较治疗前下降,差异有统计学意义(P<0.05),且观察组体重、收缩压、舒张压、TG、血尿酸、UACR治疗后的变化值较对照组差异有统计学意义(P<0.05).治疗8周时,观察组有3例(5.0%)发生5次轻度低血糖事件,对照组有8例(12.7%)发生15次轻度低血糖事件,差异有统计学意义(χ^(2)=4.25,P=0.030),观察组1例女性患者发生泌尿系感染,中途退出研究;观察组共有8例(13.1%)出现胃纳减退、轻度恶心感,观察组胃肠道不良反应明显高于对照组(χ^(2)=8.61,P<0.01).结论对新诊断的超重的2型糖尿病患者,达格列净联合利拉鲁肽治疗的疗效与基础-餐时胰岛素强化治疗疗效相似,同时还具有减轻体重、降低血压、减少低血糖风险的优势.
Objective To evaluate the efficacy and safety of dapagliflozin plus liraglutide and basal-bolus insulin therapy in newly diagnosed overweight patients with type 2 diabetes mellitus.Methods A total of 124 newly diagnosed overweight type 2 diabetes patients were recruited from January 2019 to June 2020 in the Department of Endocrinology of The Tongxiang First People's Hospital.The patients were randomly divided into dapagliflozin plus liraglutide therapy group(experimental group)and basic-bolus insulin therapy group(control group)according to the random number table method.The control group was injected with asparagine insulin before three meals and glargine insulin before going to bed,and was observed for 8 weeks.The time of blood glucose reaching standard time,the changes of FPG,the 2hPG,the HbAlc,the body weight,the blood pressure and the blood lipids from baseline and the adverse events in 2 groups after treatment were evaluated.Results The blood glucose standard time of experimental group and control group was(6.5±1.8)and(5.9±1.7)d,respectively,the differences were not stistially significant.Afer 8 weeks of the treatment,FPG,2 hPG,HbA1c,TG,TC and LDL-C in both groups decreased significantly,and HDL-C was higher than baseline level,the differences were statistically significant(P<0.01).In the experimental group,the body weight,the systolic blood pressure,the diastolic blood pressure,the blood uric acid and UACR decreased after treatment,the dferences were statistically significant(P<0.05).Compare to the control group,the changes of body weight,the systolic blood pressure,the diastolic blood pressure,TG,the blood uric acid and UACR in the experimental group were significantly diferent(P<0.05).After 8 weeks of treatment,3 patients(5.0%)in the experimental group had 5 mild hypoglycemia,while 8 patients(12.7%)in the control group had 15 mild hypoglycemia,the difference was statistically significant(χ^(2)=4.25,P=0.030).One female patient in the experimental group had urinary tract infection and was withdrawn from the study.A total of 8 patients(13.1%)in the experimental group showed hypogastric appetite and mild nausea,and the gastrointestinal adverse reactions in the experimental group were significantly higher than those in the control group(χ^(2)=8.61,P<0.01).Conclusion For newly diagnosed overweight type 2 diabetic patients,the efficacy of dapagliflozin plus liraglutide is similar to the basal-bolus insulin therapy,but it also has the advantages of body weight loss,reducing blood pressure,less hypoglycemia risk.
出处
《浙江临床医学》
2022年第12期1818-1821,共4页
Zhejiang Clinical Medical Journal
基金
桐乡市科技计划项目(202002130)。
