临床荟萃 ›› 2016, Vol. 31 ›› Issue (3): 303-306.doi: 10.3969/j.issn.1004-583X.2016.03.018

• 论著 • 上一篇    下一篇

艾塞那肽治疗肥胖2型糖尿病的疗效

李亚娟,赵若飞,李红,戴强   

  1. 张家港市中医医院 内分泌科,江苏 张家港 215600
  • 收稿日期:2015-10-10 出版日期:2016-03-05 发布日期:2016-04-18
  • 通讯作者: 李亚娟,Email:erpangdejia@sohu.com

Clinical study on exenatide treatment of obese type 2 diabetes mellitus

Li Yajuan, Zhao Ruofei, Li Hong, Dai Qiang   

  1. Department of Endocrinology,Zhangjiagang Hospital of Traditional Chinese Medicine Zhangjiagang 215600,China
  • Received:2015-10-10 Online:2016-03-05 Published:2016-04-18
  • Contact: Li Yajuan,Email:erpangdejia@sohu.com.cn

摘要: 目的 对艾塞那肽在控制血糖、改善胰岛B细胞功能、减轻胰岛素抵抗以及不良事件发生率等方面进行疗效和安全性的评估。方法 口服降糖药血糖控制较差的肥胖2型糖尿病(T2DM)患者60例,随机分为艾塞那肽组(n=30)和门冬胰岛素30组(n=30),其中艾塞那肽组采用艾塞那肽5 μg,每日2次皮下注射,4周之后剂量增至10 μg,每日2次皮下注射;门冬胰岛素30组采用门冬胰岛素30皮下注射,根据患者的血糖水平制定起始剂量,餐前注射,每隔1~2天调整胰岛素用量。记录治疗前和治疗12周末患者的一般资料、血糖情况、胰岛功能、血脂、胰岛素抵抗指数、不良反应及低血糖事件进行疗效及安全性判定。结果 艾塞那肽组血糖、体质量指数、血脂、胰岛素抵抗指数、胰岛功能指数改善明显优于门冬胰岛素30组(P<0.05),且无低血糖发生,仅有轻微胃肠道不良反应。结论 对于血糖控制不佳的肥胖T2DM患者,艾塞那肽治疗效果明显优于门冬胰岛素30,是更好的选择方案之一。

关键词: 糖尿病, 2型, 胰高血糖素样肽1, 二甲双胍

Abstract: Objective This paper focuses on the effect and safety evaluation of the therapy of exenatide for obese T2DM patients in the control of blood glucose, improvement of pancreatic beta cell function, alleviation of insulin resistance, evaluation of the incidence of adverse events and other aspects of efficacy and safety.Methods In this study, 60 cases of obese T2DM patients with undesirable blood glucose control results from oral administration of hypoglycemic agents were selected. Patients were randomly divided into exenatide group (n=30) and insulin aspart 30 group (n=30). Subcutaneous injection 5 μg exenatide twice a day was applied to the exenatide group, dosage was increased to 10 μg after one month; Subcutaneous injection of insulin aspart 30 twice a day was applied to the insulin aspart 30 group, initial dosages depending on the blood glucose level of patient. All injections were applied before meals with dosages adjusted every 1 or 2 days. Observing period lasted for 12 weeks. Information of patients in both groups before and after therapy were observed and recorded, such as general information, blood glucose, islet function, blood fat, insulin resistance index and also occurrence of adverse drug reaction and low glucose to determine its efficacy and safety.Results Blood glucose, body mass index, blood fat, insulin resistance index, the index of islet function in the exenatide group improved significantly better than insulin aspart 30 group(P<0.05),without hypoglycemia, and there were only slight gastrointestinal adverse reactions.Conclusion For obese patients with type 2 diabetes, the treatment effect is obviously better than insulin aspart 30, exenatide is one of the better alternative options than insulin aspart 30.

Key words: diabetes mellitus,type 2, glucagon-like peptide 1, metformin

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