新疆医科大学学报

目的 探讨甘精胰岛素联合利拉鲁肽治疗血糖控制不佳2型糖尿病(T2DM)的效果。方法 收集淮南阳光新康医院2021年1月至2023年6月收治的100例血糖控制不佳的T2DM患者，按照随机数字表法分为两组，每组50例。在常规治疗的基础上，对照组采用利拉鲁肽治疗，研究组采用利拉鲁肽联合甘精胰岛素治疗。连续治疗3个月后，比较两组疗效、不良反应、利拉鲁肽的每日剂量、血糖水平[空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbAlc)、血糖波动幅度(MAGE)、葡萄糖目标范围内时间占比(TIR)]、胰岛β细胞功能[空腹胰岛素(FINS)、C肽(CP)、胰岛素抵抗指数(HOMA-IR)]、肝肾损伤情况[丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、尿白蛋白/肌酐比值(UACR)]。结果 治疗后研究组的总有效率(96.00%)高于对照组(82.00%)。治疗后研究组的FPG、2 h PG、HbAlc、MAGE、FINS、HOMA-IR、UACR水平及利拉鲁肽的每日剂量均低于对照组，TIR、CP水平均高于对照组，差异均有统计学意义(P<0.05)。两组血清ALT、AST水平及不良反应发生率比较，差异均无统计学意义(P>0.05)。结论 与常规治疗配合利拉鲁肽相比，甘精胰岛素联合利拉鲁肽及常规治疗可提高血糖控制不佳T2DM患者的治疗效果，较好地控制血糖，改善胰岛β细胞功能和肾功能，降低利拉鲁肽的剂量，且不会增加不良反应的发生。

Objective To analyze the effect of insulin glargine combined with liraglutide in the treatment of type 2 diabetes mellitus with poor glycemic control. Methods 100 T2DM patients with poor blood glucose control admitted to the hospital from January 2021 to June 2023 were collected and divided into 2 groups according to random number table method, with 50 cases in each group. On the basis of conventional treatment, the control group was treated with liraglutide, and the study group was treated with liraglutide combined with insulin glargine. After 3 months of continuous treatment, the efficacy, adverse reactions, daily dose of liraglutide, and blood glucose levels [fasting plasma glucose(FPG), 2-hour postprandial glucose(2 h PG), glycated hemoglobin(HbAlc), mean amplitude of glucose excursions(MAGE), in range(TIR)] before and after the treatment, pancreatic β-cell function [fasting insulin(FINS), C-peptide(CP), homeostasis assessment of insulin resistance(HOMA-IR)], and liver and kidney injury [alanine aminotransferase(ALT), aspartate aotransferase(AST), urine albumin/creatinine ratio(UACR)], before and after treatment were compared between the two groups. Results After treatment the total effective rate of the study group(96.00%) was higher than that of control group(82.00%), the levels of FPG, 2 h PG, HbAlc, MAGE, FINS, HOMA-IR, UACR and daily dose of lilaglutide in the study group were lower than those in the control group, and the TIR value and CP levels were higher than those in the control group.The differences were statistically significant(P<0.05). There was no significant difference in serum ALT and AST levels and incidence of adverse reactions between the 2 groups(P>0.05). Conclusion Compared with conventional therapy combined with liraglutide, insulin glargine combined with liraglutide and conventional therapy can improve the therapeutic effect of type 2 diabetes patients with poor glycemic control, better control blood glucose, improve the function of islet beta cells and renal function, reduce the dose of liraglutide, and do not increase the occurrence of adverse reactions.