[1]刘璠,张趁儒,周慧敏,等.2型糖尿病患者利拉鲁肽替代预混胰岛素治疗的有效性和安全性分析[J].国际内分泌代谢杂志,2014,(04):237-240.[doi:10.3760/cma.j.issn.1673-4157.2014.04.006]
　Liu Fan,Zhang Chenru,Zhou Huimin,et al.Efficacy and safety of liraglutide switched from premixed insulin in patients with type 2 diabetes mellitus[J].International Journal of Endocrinology and Metabolism,2014,(04):237-240.[doi:10.3760/cma.j.issn.1673-4157.2014.04.006]
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2型糖尿病患者利拉鲁肽替代预混胰岛素治疗的有效性和安全性分析()
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《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
期数:
2014年04期
页码:
237-240
栏目:
论著
出版日期:
2014-08-31

文章信息/Info

Title:
Efficacy and safety of liraglutide switched from premixed insulin in patients with type 2 diabetes mellitus
作者:
刘璠; 张趁儒; 周慧敏; 杜丽娜; 杨爱格; 康岩; 王丽娜
作者单位：050031　石家庄，河北医科大学第一医院内分泌科 　　
Author(s):
Liu Fan; Zhang Chenru; Zhou Huimin; Du Lina; Yang Aige; Kang Yan; Wang Lina.
Department of Endocrinology，The First Hospital of Hebei Medical University，Shijiazhuang 050031，China Corresponding author：Zhou Huimin，Email：liufan8130@sina.com
关键词:
2型糖尿病; 利拉鲁肽; 预混胰岛素; 糖化血红蛋白; 低血糖
Keywords:
Type 2 diabetes mellitus; Liraglutide; Premixed insulin; Hemoglobin A1c; Hypoglycemia
DOI:
10.3760/cma.j.issn.1673-4157.2014.04.006
摘要:
目的　评价应用预混胰岛素治疗效果欠佳的2型糖尿病患者转为利拉鲁肽治疗的有效性和安全性。方法　选取河北医科大学第一医院内分泌科应用预混胰岛素治疗血糖欠佳的2型糖尿病患者80例随机分为利拉鲁肽组（n = 40）及预混胰岛素组（n = 40），利拉鲁肽组再根据HbA1c是否≤ 8%且预混胰岛素量是否≤ 40 U/d分为4个亚组，分别给予利拉鲁肽（1.2～1.8 mg/d）及预混胰岛素治疗，疗程24周。分别于试验第0、12、24周时测空腹血糖、餐后2 h血糖（2 h PG）、糖化血红蛋白（HbA1c）；试验第0周和24周测体重指数，进行患者满意度调查；全程记录低血糖事件的发生情况。结果　第24周时，利拉鲁肽组HbA1c[（6.82±0.42）% vs. （7.07±0.44）%]、HbA1c达标率[76.9% vs. 47.4% ]、体重指数[23.04±1.47 vs. 24.85±2.45 ]、低血糖发生率[2.6% vs. 26.3% ]及患者满意度[（6.44±1.50） vs.（4.77±1.72），（6.97±1.68）vs.（4.82±1.85），（6.85±1.68）vs.（4.62±1.73），（6.31±2.15）vs.（5.05±1.76） ]显著优于预混胰岛素组（P均＜0.05）。利拉鲁肽组中试验前预混胰岛素用量≤ 40 U/d且HbA1c ≤ 8%的患者HbA1c达标率（100% vs. 80%, 72.7%, 55.6%）显著高于其他亚组（P ＜0.01）。 结论　应用预混胰岛素治疗效果欠佳的2型糖尿病患者转为利拉鲁肽治疗后获得良好的降糖效果及安全性。
Abstract:
Objective　To evaluate the efficacy and safety of liraglutide switched from premixed insulin in patients with type 2 diabetes mellitus（T2DM） inadequately controlled by premixed insulin. Methods　Overall，80 patients who visited the Department of Endocrinology of the First Hospital of Hebei Medical University with T2DM inadequately controlled by premixed insulin were randomized into liraglutide group （n = 40） and premixed insulin group（n = 40），and the liraglutide group was divided into four subgroups according to the level of hemoglobin A1c（HbA1c） and premixed insulin dose. During the 2-week run-in period and the 22-week treatment period，patients in the liraglutide group transferred to liraglutide from premixed insulin， and patients in the premixed insulin group continued the premixed insulin treatment. At week 0，12，and 24 of the clinic trial，fast blood glucose，2 hour postprandial blood glucose and HbA1c were measured. Patient satis-faction was investigated and body mass index was measured at week 0 and 24，with all hypoglycemic events during the trial recorded as well. Results　The HbA1c level[（6.82±0.42）% vs.（7.07±0.44）%]，percentage of patients achieving HbA1c＜7%（76.9% vs. 47.4%）， body mass index [（23.04±1.47）vs.（24.85±2.45）]，incidence of hypoglycemia（2.6% vs. 26.3%） and the patient satisfaction[（6.44±1.50）vs.（4.77±1.72），（6.97±1.68）vs.（4.82±1.85），（6.85±1.68）vs.（4.62±1.73），（6.31±2.15）vs.（5.05±1.76）] at week 24 of the clinic trial in the liraglutide group were all improved compared with those in premixed group （all P＜0.05）. In the liraglutide group，the percentage of patients achieving HbA1c＜7% in patients with premixed insulin dose ≤ 40 U/d and HbA1c level ≤8%（100% vs. 80%， 72.7%， 55.6%）was the highest among all subgroups （P＜0.01）. Conclusion　Switching from premixed insulin to liraglutide is effective and safe in patients with T2DM inadequately controlled by premixed insulin.

参考文献/References:

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备注/Memo

备注/Memo:
基金项目：河北省卫生厅医学科学研究重点课题计划项目（20130265） 通信作者：周慧敏， Email:zhouhuimindoctor@163.com
更新日期/Last Update: 2014-07-20