Objective 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.
Methods 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.
Results 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).
Conclusion 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.
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