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目的观察应用利拉鲁肽与甘精胰岛素治疗2型糖尿病患者的疗效和安全性。方法 60例口服二甲双胍和磺脲类药物血糖控制不佳的2型糖尿病患者,随机分为两组,每组30例。在服用原药基础上,利拉鲁肽组联合应用利拉鲁肽,甘精胰岛素组联合应用甘精胰岛素,疗程均为12周。检测治疗前后患者体重指数(BMI)、空腹血糖(FBG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA_(1c))、空腹C肽水平和胰岛素抵抗指数(HOMA-IR),并观察不良反应。结果治疗后,利拉鲁肽组患者BMI降低,而甘精胰岛素组上升,组间差异非常显著(P<0.01)。两组FBG、2hPG及HbA_(1c)均明显下降(P<0.01),组间无显著差异(P>0.05)。两组空腹C肽均升高,利拉鲁肽组升高幅度大于甘精胰岛素组(P<0.01)。利拉鲁肽组HOMA-IR明显改善,两组间有显著差异(P<0.01)。两组均无严重不良反应发生,利拉鲁肽组发生低血糖1例,甘精胰岛素组3例。结论利拉鲁肽与甘精胰岛素在控制血糖方面同样有效、安全,利拉鲁肽改善HOMA-IR及减轻体重作用强于甘精胰岛素。
Objective To observe the efficacy and safety of the application of liraglutide and insulin glargine in patients with type 2 diabetes mellitus. Methods Sixty patients with type 2 diabetes who had poor glycemic control of metformin and sulfonylureas were randomly divided into two groups of 30 patients. On the basis of taking the original drug, liraglutide combined with liraglutide, insulin glargine combined with glargine for 12 weeks. The body mass index (BMI), fasting blood glucose (FBG), postprandial 2h blood glucose (2hPG), HbA 1c, fasting C-peptide and insulin resistance index (HOMA-IR) were measured before and after treatment. Adverse reactions. Results After treatment, the BMI decreased in the liraglutide group, but increased in the insulin glargine group (P <0.01). FBG, 2hPG and HbA_ (1c) in both groups were significantly decreased (P <0.01), no significant difference between the two groups (P> 0.05). Fasting C-peptide levels were increased in both groups, and the increase in liraglutide group was greater than that in insulin glargine group (P <0.01). HOMA-IR in liraglutide group was significantly improved, with significant difference between the two groups (P <0.01). There were no serious adverse reactions in both groups, one in hypoglycemia and three in insulin glargine. Conclusions Liraglutide and insulin glargine are equally effective and safe in controlling blood glucose. Liraglutide is more effective than insulin glargine in improving HOMA-IR and reducing body weight.