利拉鲁肽与格列美脲对胰岛素泵治疗欠佳2型糖尿病患者的安全性和血管获益的对比研究.

OBJECTIVE: To probe into the effects of liraglutide and glimepiride in the treatment of patients with inadequately glycemic controlled type 2 diabetes with insulin pump and its adverse drug reactions. METHODS: Totally166 patients with type 2 diabetes admitted into Hengshui People’s Hospital from Aug. 2018 to Aug. 2020 were extracted, after 7 d of continuous treatment with subcutaneous insulin pump ( insulin dosage ＞ 0. 7 IU/kg), the blood glucose was still not up to standard. All patients were divided into the research group ( n = 84) and the control group ( n = 82) via the random number table. The control group was treated with glimepiride, while the research group received liraglutide. Peripheral blood biochemical indicators [glycated hemoglobin ( HbA1 c), fasting blood glucose ( FBG), 2 h postprandial blood glucose ( 2 h PG), triglycerides ( TG), total cholesterol ( TC), high-density lipoprotein cholesterol ( HDL-C), low-density lipoprotein cholesterol ( LDL-C), lipoprotein-related phospholipase A2 ( Lp-PLA2) and high-sensitivity C-reactive protein ( hs-CRP) ], insulin-related indicators [fasting insulin ( FINS), homeostasis model assessment of insulin resistance ( HOMA-IR) ], renal function indicators [serum uric acid ( SUA), creatinine ( SCr), urinary protein excretion rate ( UAER) and urine microalbumin/urinary creatine liver ( ACR) ]and vascular function of both lower limbs [intravascular median membrane thickness ( IMT), peak systolic velocity ( PSV)and stenosis rate] and adverse drugs reactions of two groups were recorded before treatment and after treatment of3 months. RESULTS: After treatment of 3 months, the levels of HbA1 c, FBG, 2 h PG, TG, TC, LDL-C, Lp-PLA2 and hs-CRP in two groups were significantly lower than those before treatment, while the levels of HDL-C were significantly higher than those before treatment; compared with the control group, the levels of HbA1 c, FBG, 2 hPG, TG, TC, LDL-C, Lp-PLA2, hs-CRP and other biochemical indicators in the research group decreased significantly, while the levels of HDL-C increased significantly, with statistically significant difference ( P ＜ 0. 05). After treatment of 3 months, the levels of FINS, HOMA-IR and other indicators in two groups were significantly lower than those before treatment, and the levels of FINS and HOMA-IR in the research group were significantly lower than those in the control group, and the differences were statistically significant ( P ＜ 0. 05). After treatment of 3 months, the levels of renal function indicators such as UAER, SCr, SUA and ACR, and vascular function indicators such as IMT, PSV and stenosis rate of two groups were significantly lower than those before treatment; and the levels of the above renal function indicators and vascular function indicators of the research group were significantly lower than those of the control group, the differences were statistically significant ( P ＜ 0. 05). There were no severe adverse drug reactions in two groups after treatment. CONCLUSIONS: The efficacy of insulin pump combined with liraglutide is better than glimepiride in the treatment of patients with type 2 diabetes. Liraglutide has a more significant effect on blood glucose, blood lipids, islet function and renal function, and has higher safety. [ABSTRACT FROM AUTHOR]