Citation: | MIAO Jia, ZHANG Liuliu, LIU Mengxue. Efficacy observation of dulaglutide combined with insulin glargine in treating patients with type 2 diabetes mellitus[J]. Journal of Clinical Medicine in Practice, 2024, 28(7): 96-100. DOI: 10.7619/jcmp.20233147 |
To investigate the effects of dulaglutide combined with insulin glargine on glucose and lipid metabolism, pancreatic islet function, oxidative stress and bone metabolism indicators in patients with type 2 diabetes mellitus.
A total of 98 patients with type 2 diabetes mellitus were randomly divided into insulin glargine group and combined group, with 49 cases in each group. The insulin glargine group was treated with insulin glargine and metformin, while the combined group was treated with dulaglutide, insulin glargine and metformin. The levels of blood glucose, blood lipids and pancreatic islet function were compared between the two groups before and after treatment; enzyme immunoassay analyzer was used to detect the levels of oxidative stress indicators; immunoturbidimetry was used to detect bone metabolism indicators; the urinary microalbumin to creatinine ratio (UACR) was calculated in both groups, and the therapeutic effect was compared between the two groups.
After treatment, the levels of fasting plasma glucose (FPG), 2-hour postprandial glucose (2 hPG) and glycated hemoglobin (HbA1c) in the combined group were significantly lower than those in the insulin glargine group (P<0.05). After treatment, the levels of total cholesterol (TC), triglycerides (TG) and low-density lipoprotein cholesterol (LDL-C) in the combined group were significantly lower than those in the insulin glargine group, while the level of high-density lipoprotein (HDL) was significantly higher than that in the insulin glargine group (P<0.05). After treatment, the homeostatic model assessment of insulin secretion (HOMA-IS) in the combined group was significantly higher than that in the insulin glargine group, while the homeostatic model assessment of insulin resistance (HOMA-IR) was significantly lower than that in the insulin glargine group (P<0.05). After treatment, the levels of catalase (CAT) and osteocalcin (OC) in the combined group were significantly higher than those in the insulin glargine group, while the levels of lipid peroxide (LPO) and β-collagen degradation products (β-CTX) were significantly lower than those in the insulin glargine group (P<0.05). After treatment, the UACR in the combined group was (33.26±3.37) mg/g, which was significantly higher than (25.49±2.83) mg/g in the insulin glargine group (P<0.05). The total effective rate in the combined group was 93.88%, which was significantly higher than 79.59% in the insulin glargine group (P<0.05).
Dulaglutide combined with insulin glargine can effectively regulate the blood glucose and lipid levels of patients with type 2 diabetes, improve the function of pancreatic islets, alleviate the oxidative stress reaction, improve bone metabolism, and regulate the UACR level.
[1] |
SANZ-CÁNOVAS J, LÓPEZ-SAMPALO, COBOS-PALACIOS L, et al. Management of type 2 diabetes mellitus in elderly patients with frailty and/or sarcopenia[J]. Int J Environ Res Public Health, 2022, 19(14): 8677. doi: 10.3390/ijerph19148677
|
[2] |
韩秀平, 谭娟, 贺钰梅. 不同尿白蛋白排泄率2型糖尿病患者微小RNA-34a、缺氧诱导因子-1α水平及意义[J]. 实用临床医药杂志, 2023, 27(5): 114-118. doi: 10.7619/jcmp.20221742
|
[3] |
KIM H J, KIM K I. Blood pressure target in type 2 diabetes mellitus[J]. Diabetes Metab J, 2022, 46(5): 667-674. doi: 10.4093/dmj.2022.0215
|
[4] |
麦华德, 宋艳玲, 陈明慧, 等. 二甲双胍联合格列美脲或达格列净对2型糖尿病患者胰岛功能及生活质量的影响[J]. 实用临床医药杂志, 2021, 25(16): 61-64, 69. doi: 10.7619/jcmp.20211691
|
[5] |
DAO L S, CHOI S, FREEBY M. Type 2 diabetes mellitus and cognitive function: understanding the connections[J]. Curr Opin Endocrinol Diabetes Obes, 2023, 30(1): 7-13. doi: 10.1097/MED.0000000000000783
|
[6] |
ZHAO Y M, LI Y Y, ZHUANG Z H, et al. Associations of polysocial risk score, lifestyle and genetic factors with incident type 2 diabetes: a prospective cohort study[J]. Diabetologia, 2022, 65(12): 2056-2065. doi: 10.1007/s00125-022-05761-y
|
[7] |
杨雀, 陈伟国, 高海燕, 等. 德谷门冬双胰岛素和甘精胰岛素治疗预混胰岛素血糖控制不佳2型糖尿病疗效及安全性研究[J]. 陕西医学杂志, 2023, 52(1): 86-88. https://www.cnki.com.cn/Article/CJFDTOTAL-SXYZ202301020.htm
|
[8] |
丁美. 度拉糖肽注射液在不同体质量指数2型糖尿病患者中的临床疗效[J]. 中国实用医药, 2023, 18(4): 127-130. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSSA202304038.htm
|
[9] |
陆菊明. 《中国2型糖尿病防治指南(2020年版)》读后感[J]. 中华糖尿病杂志, 2021, 13(4): 301-304.
|
[10] |
GOMEZ E J. Institutions, crisis and type 2 diabetes policy in Venezuela[J]. BMJ Glob Health, 2022, 7(Suppl 5): e007174. doi: 10.1136/bmjgh-2021-007174
|
[11] |
BARONI I, CARUSO R, DELLAFIORE F, et al. Self-care and type 2 diabetes mellitus (T2DM): a literature review in sex-related differences[J]. Acta Biomed, 2022, 93(4): e2022277.
|
[12] |
何秀丽, 邓大同. 达格列净片联合盐酸二甲双胍片及甘精胰岛素注射液治疗老年2型糖尿病的临床效果[J]. 中国老年学杂志, 2022, 42(21): 5188-5191. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLXZ202221010.htm
|
[13] |
纪汶君, 门鹏, 李娜, 等. 度拉糖肽治疗2型糖尿病快速卫生技术评估[J]. 中国药业, 2023, 32(6): 109-115. https://www.cnki.com.cn/Article/CJFDTOTAL-YYGZ202306028.htm
|
[14] |
ZHOU C, WANG M, LIANG J L, et al. Ketogenic diet benefits to weight loss, glycemic control, and lipid profiles in overweight patients with type 2 diabetes mellitus: a meta-analysis of randomized controlled trails[J]. Int J Environ Res Public Health, 2022, 19(16): 10429. doi: 10.3390/ijerph191610429
|
[15] |
WU Y R, WONG C W, CHILES E N, et al. Glycerate from intestinal fructose metabolism induces islet cell damage and glucose intolerance[J]. Cell Metab, 2022, 34(7): 1042-1053. e6. doi: 10.1016/j.cmet.2022.05.007
|
[16] |
马丁, 马昌军, 卢富琨, 等. 度拉糖肽联合氢氯噻嗪对高血压合并糖尿病患者血压与血脂及氧化应激的影响[J]. 中国临床保健杂志, 2023, 26(1): 86-89. https://www.cnki.com.cn/Article/CJFDTOTAL-LZBJ202301019.htm
|
[17] |
HEISE T, MARI A, DEVRIES J H, et al. Effects of subcutaneous tirzepatide versus placebo or semaglutide on pancreatic islet function and insulin sensitivity in adults with type 2 diabetes: a multicentre, randomised, double-blind, parallel-arm, phase 1 clinical trial[J]. Lancet Diabetes Endocrinol, 2022, 10(6): 418-429. doi: 10.1016/S2213-8587(22)00085-7
|
[18] |
LUO W, ZHOU J L, YANG X, et al. A Chinese medical nutrition therapy diet accompanied by intermittent energy restriction alleviates type 2 diabetes by enhancing pancreatic islet function and regulating gut microbiota composition[J]. Food Res Int, 2022, 161: 111744. doi: 10.1016/j.foodres.2022.111744
|
[19] |
MAHJABEEN W, KHAN D A, MIRZA S A. Role of resveratrol supplementation in regulation of glucose hemostasis, inflammation and oxidative stress in patients with diabetes mellitus type 2: a randomized, placebo-controlled trial[J]. Complement Ther Med, 2022, 66: 102819. doi: 10.1016/j.ctim.2022.102819
|
[20] |
ĈATER M, KRIŽANĈIC BOMBEK L. Protective role of mitochondrial uncoupling proteins against age-related oxidative stress in type 2 diabetes mellitus[J]. Antioxidants, 2022, 11(8): 1473. doi: 10.3390/antiox11081473
|
[21] |
张勤凤, 李欢, 胡婧, 等. 度拉糖肽对2型糖尿病患者骨代谢标志物的影响及其可能机制[J]. 中国医药科学, 2023, 13(8): 91-93, 113. https://www.cnki.com.cn/Article/CJFDTOTAL-GYKX202308022.htm
|