摘要目的 观察胰高血糖素样肽1(GLP-1)类似物利拉鲁肽联合胰岛素治疗肥胖或超重的2型糖尿病患者临床疗效及安全性.方法 选取肥胖或超重(体质量指数≥24)的2型糖尿病患者40例,既往均使用胰岛素治疗,血糖控制不佳(糖化血红蛋白≥7.5％),随机分为两组(每组20例),A组加用利拉鲁肽,B组单纯调整胰岛素剂量.治疗12周后,观察两组空腹血糖、餐后2h血糖、糖化血红蛋白、体质量及胰岛素用量,并记录低血糖发生次数及不良反应.结果 治疗12周后,A组体质量及每天胰岛素剂量明显低于B组(t =2.738、2.865,均P＜0.01).A组发生低血糖6例次(30％),B组9例次(45％),两组差异无统计学意义(x2 =0.96,P＞0.05).结论 利拉鲁肽联合胰岛素治疗肥胖或超重的2型糖尿,可明显减少体质量及每天胰岛素剂量,不增加低血糖发生率,安全有效.

abstractsObjective To observe the therapeutic efficacy and safety of the glucagon-like peptide-1 ( GLP-1 )analogue combined with isulin for treating obese or overweight type 2 diabetes.Methods 40 cases with obese or overweight type 2 diabetic patients( body mass index(BMI) ≥24) who have previously used human insulin,and experienced poor glycemic control( ≥7.5％ ) were selected.They were randomly divided into two groups.A group treated by GLP-1 analogue liraglutide plus insulin,and B group by continuous adjustment of insulin.12 weeks later,fasting blood glucose(FBG),2-hour plasma glucose (2hPG),hemoglobin A 1 C (HbA1c),body weight were observed and the incidence of hypoglycemia,insulin dosage were recorded.Results Weight and insulin dosage of group A was significantly lower than those of group B after treatment 12 week( t =2.738,2.865,all P ＜ 0.01 ).Numbers of hypoglycemia events were 6 in group A(30％ ),and 9 in group B(45％ ),but there was no statistical significance between the two groups ( P ＞ 0.05).Conclusion The addition of liraglutide to insulin in patients with obese or overweight type 2 diabetes is associated with reductions in weight and insulin dosage,without increase risk of hypoglycemia.This treatment proved effective and safe.