摘要
目的评估度拉糖肽与利拉鲁肽对初诊2型糖尿病(T2DM)患者短期胰岛素强化治疗的效果与后续结果的影响。方法采用双向性观察研究,收集2022年在东莞市松山湖中心医院进行胰岛素强化治疗的初诊T2DM伴高血糖状态患者,分为度拉糖肽组和利拉鲁肽组,并对住院期间数据和出院后16周的随访数据以及治疗方案进行统计分析。结果共收集到128例符合纳排标准的患者,其中利拉鲁肽组65例,度拉糖肽组63例。①住院期间,度拉糖肽组血糖达标时间更短(P<0.05),并且需胰岛素序贯治疗率更低(P<0.05)。②出院1、4、10、12、13~16周度拉糖肽组血糖均低于利拉鲁肽组,第12周后,度拉糖肽组的空腹及餐后血糖、糖化血红蛋白、空腹血浆血糖均低于利拉鲁肽组(P<0.05),且两组研究药物使用时长差异无统计学意义(P>0.05)。③治疗期间未观察到严重不良反应,主要不良反应为恶心、呕吐、便秘、腹泻、低血糖,两组总体不良反应发生率差异无统计学意义(P>0.05)。结论度拉糖肽与利拉鲁肽应用于短期胰岛素强化治疗,安全性均较好。度拉糖肽组降糖时间更短,出院方案更简单,且随着时间延长降糖效果更显著。度拉糖肽应用于胰岛素强化方案可能更适合初诊T2DM伴有高血糖状态患者。
Objective To evaluate the efficacy and safety of dulaglutide and liraglutide on newly diagnosed T2DM patients with short-term intensive insulin therapy(SIIT)and subsequent outcomes.Methods Newly diagnosed T2DM patients with hyperglycemic state undergoing insulin intensification in Songshan Lake Central Hospital in 2022 were assigned to dulaglutide group and liraglutide group.The data of patients during hospitalization and follow-up(at 16 weeks after discharge)and treatment plan were statistically analyzed.Results A total of 128 patients were collected,including 65 cases in liraglutide group and 63 cases in dulaglutide group.①During hospitalization,compared with liraglutide group,the blood glucose reached the standard faster in dulaglutide group(P<0.05);the rate of GLP-1RA combined with continuous subcutaneous insulin infusion,(CSII) was lower(P<0.05).②The blood glucose of dulaglutide group was lower than that of liraglutide group at 1 week,4 weeks,10 weeks,12 weeks and 13~16 weeks after discharge.After the 12nd week,the fasting blood glucose,postprandial blood glucose,glycated hemoglobin and fasting plasma blood glucose of dulaglutide group were lower than those of liraglutide group(P<0.05).There was no significant difference in duration of drug use between the two groups(P>0.05).③There was no severe adverse drug reaction(ADR)in the two groups.The main ADR included nausea,vomiting,constipation,diarrhea,and hypoglycemia.There was no significant difference in the incidence of ADR between the two groups(P>0.05).Conclusion Both dulaglutide and liraglutide have good safety in short-term intensive insulin therapy,and dulaglutide group has shorter hypoglycemic duration,simpler discharge plan,and more significant hypoglycemic effect over time.Therefore,Dulaglutide in SIIT may be more suitable for newly diagnosed T2DM patients with hyperglycemia state.
作者
罗叶
秦又发
黄志荣
陆秋平
贺露霄
Luo Ye;Qin Youfa;Huang Zhirong;Lu Qiuping;He Luxiao(School of Pharmacy,Guangdong Medical University,Dongguan 523109,China;Songshan Lake Central Hospital,Dongguan 523326,China;School of Pharmaceutical Sciences,Southern Medical University,Guangzhou 510515,China)
出处
《实用药物与临床》
CAS
2024年第4期255-259,共5页
Practical Pharmacy and Clinical Remedies
基金
中国医药教育协会《临床用药卫生技术评估》专项课题立项(2023WSJSPGZXKT-47)
东莞市松山湖中心医院院内重大科研项目培育基金(SZR005)
东莞市社会发展科技重点项目(20231800940392)。
