天津医药

天津医药 ›› 2022, Vol. 50 ›› Issue (6): 663-667.doi: 10.11958/20212432

• 药物临床观察 • 上一篇    下一篇

利拉鲁肽联合德谷胰岛素对2型糖尿病患者血糖波动的影响

姚明言1，张靖2，王杰3，李志红1△，尹飞1   

  1. 1保定市第一中心医院内分泌科（邮编071000）；2河北大学附属医院心内科；3首都医科大学附属北京朝阳医院内分泌科
  • 收稿日期:2021-10-27 修回日期:2022-02-08 出版日期:2022-06-15 发布日期:2023-12-20
  • 通讯作者: 李志红 E-mail:lizhihongmd@163.com
  • 基金资助:
    河北省医学适用技术追踪项目（GZ2021055）；保定市科学技术研究与发展指导计划项目（2041ZF076）

Effects of liraglutide combined with insulin degludec on blood glycemic variability in patients with type 2 diabetes mellitus

YAO Mingyan1, ZHANG Jing2, WANG Jie3, LI Zhihong1△, YIN Fei1   

  1. 1 Department of Endocrinology, Baoding First Central Hospital, Baoding 071000, China; 2 Department of Cardiology, Affiliated Hospital of Hebei University; 3 Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University
  • Received:2021-10-27 Revised:2022-02-08 Published:2022-06-15 Online:2023-12-20

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摘要： 摘要：目的　应用扫描式葡萄糖监测（FGM）评估利拉鲁肽和德谷胰岛素短期联合应用与基础-餐时胰岛素相比在降低血糖波动（GV）、葡萄糖目标范围内时间（TIR）和氧化应激水平方面的差异。方法　采用平行对照设计，将应用每日多次胰岛素注射（MDI）至少1个月的2型糖尿病患者以随机数字表法按1∶1分为2组，基础-餐时胰岛素组（对照组，n=26）和德谷胰岛素联合利拉鲁肽组（试验组，n=26）。主要研究终点为治疗14 d后GV参数和TIR与基线相比的变化。次要研究终点为低血糖情况、氧化应激水平和体质量较基线改变情况。结果　治疗后2组血清1，5-脱水葡糖醇（1,5-AG）较治疗前明显升高（均P＜0.05），治疗后试验组MAGE和eHbA1c明显低于对照组，1,5-AG明显高于对照组，差异有统计学意义（均P＜0.05）。治疗后2组TIR均较治疗前明显延长，葡萄糖高于目标范围（＞10 mmol/L）时间（TAR）明显缩短，试验组葡萄糖低于目标范围（＜3.9 mmol/L）时间（TBR）低于对照组（P＜0.05）。治疗后试验组8异前列腺素F2α和8-羟基脱氧鸟苷水平较对照组降低（P＜0.05）。治疗后试验组体质量显著下降（P＜0.05），对照组无明显改变。结论　利拉鲁肽与德谷胰岛素的短期联合应用于2型糖尿病患者能获得良好的血糖控制，在改善GV、低血糖率、氧化应激水平和体质量等方面优于MDI。

关键词: 糖尿病, 2型；胰岛素；血糖；利拉鲁肽；德谷胰岛素；血糖波动；葡萄糖目标范围内时间；扫描式葡萄糖监测系统

Abstract: Abstract: Objective　To assess differences in the reduction of blood glucose fluctuations (GV), glucose target time (TIR) and oxidative stress levels in liraglutide plus insulin degludec and multiple daily insulin injections (MDI) using scanning glucose monitoring (FGM) system. Methods　In this randomized parallel-design study, subjects who were treated with MDI for at least one month were randomly assigned (through a computer-generated, random order) 1∶1 to either MDI treatment (control group, n=26) or liraglutide combined with insulin degludec treatment (experimental group, n=26). The primary endpoint of this study was the change in GV and TIR (3.9-10 mmol/L) from baseline to 14 days. Secondary endpoints included hypoglycemia, oxidative stress levels and body weight. Results The serum 1,5-anhydroglucitol (1,5-AG) was significantly increased in both groups (P＜0.05). After treatment, the MAGE and eHbA1c were significantly lower in the experimental group than those of the control group (P＜0.05), and 1,5-AG was significantly higher in the experimental group than that of the control group (P＜0.05). The TIR was significantly prolonged after treatment in both groups, and the time above range (TAR) (＞10 mmol/L) was significantly shortened. The time below range (TBR) (＜3.9 mmol/L) was significantly lower in the experimental group than that in the control group (P＜0.05). After treatment, 8-iso-PGF2α and 8-OHdG were significantly decreases in the experimental group than those of the control group (P＜0.05). After treatment, the body weights decreased significantly in the experimental group, while no significant changes in the control group (P＜0.05). Conclusion　Liraglutide combined with insulin degludec treatment can achieve good glycemic control in patients with type 2 diabetes and which is superior to MDI in improving GV, reducing hypoglycemia risk, oxidative stress levels and body weight.

Key words: diabetes mellitus, type 2, insulin, blood glucose, Liraglutide, insulin degludec, glycemic variability, time in range, flash glucose monitoring system