Clinical Observation Of Metformin And SGLT-2i Combined With GLP-1RA In The Treatment Of Type 2 Diabetes

Objective: To investigate the clinical efficacy and safety of metformin and SGLT-2i combined with GLP-1RA in the treatment of overweight/obese T2 DM patients.Methods:Select overweight/obese T2 DM patients admitted to the First Affiliated Hospital of Xinjiang Medical University from October 2021 to December 2022 and treated with "metformin and SGLT-2i based combination therapy with GLP-1RA" as the study subjects.The study subjects were treated with a "three drug combination" for 12 weeks,and their body weight,BMI,FPG,2h PBG,Hb A1 c,FC-P,HOMA-IR(C-P),lg HOMA-β(C-P),blood lipids and other related indicators were compared before and after treatment,while adverse reactions and medication compliance were recorded;Divide into "Hb A1c≤9%" group and "Hb A1c>9%" group according to the Hb A1 c results before treatment,and compare the changes in body weight and blood sugar between the two groups.Results: A total of 354 study subjects were included,and 61 patients who persisted in the combination therapy for 12 weeks and actively cooperated in reviewing relevant indicators were collected.The results of comparing various indicators before and after treatment are as follows: 1)Blood glucose related indicators: Hb A1 c,FPG,and 2-hour PBG were significantly lower than before treatment(P<0.05);FC-P、lg HOMA-β(C-P)was higher than before treatment(P<0.05),and there was no statistically significant difference in HOMA-IR(C-P)(P>0.05);2)In terms of weight loss,body weight and BMI decreased compared to before,with statistically significant differences(P<0.05);3)Effects on blood pressure and blood lipids: Blood pressure indicators(SBP,DBP)and blood lipid indicators(TC,TG,LDL-C)decreased compared to before treatment(P < 0.05),while HDL-C increased compared to before treatment(P<0.05);4)There was no statistically significant difference in renal function indicators(Sc R,e GFR)before and after treatment(P>0.05);5)There was no statistically significant difference in electrolytes(sodium,chlorine,HCO3,inorganic phosphorus)before and after treatment(P>0.05),while potassium and calcium increased compared to before treatment(P<0.05).The decrease in Hb A1 c and 2-hour PBG in the "Hb A1c>9%" group after combined treatment with three drugs was more significant than that in the "Hb A1c≤9%" group,with a statistically significant difference(P<0.05).there were no significant differences in body weight,BMI,and changes in fasting blood glucose(P>0.05).Conclusion: The "three drug combination" treatment has significant hypoglycemic and weight loss effects on overweight or obese T2 DM patients,and has a certain improvement effect on pancreatic islet β cell function.