| ObjectiveIn view of clinical observation of that improvement of liraglutide on type 2 diabetic patients with peripheral neuropathy(DPN).MethodsA total of 124 patients with type 2 diabetic peripheral neuropathy admitted to the endocrinology department of our hospital from March 2015 to July 2017 were included according to the inclusion and exclusion criteria.According to the random number table,62 cases were randomly divided into observation group and control group.The observation group was treated with liraglutide combined with diet and exercise management to control blood glucose,while the control group was treated with insulin glargine combined with diet and exercise management to control blood glucose.Both groups received continuous treatment for 4 weeks.After enrollment,before treatment and 4 weeks after treatment,the observation indexes were tested.Part I:Peripheral venous blood samples were collected for the detection of relevant indicators.Compare two groups of fasting plasma glucose(FPG),2 hours postprandial plasma glucose(2hPG),glycosylated hemoglobin(HbA1c),Blood inflammatory markers,such as high sensitivity c reactive protein(hsCRP),interleukin-6(IL-6),platelet lymphocyte ratio(PLR),homocysteine(Hcy)level,and oxidative stress indicator,such as malondialdehyde(MDA),superoxidedismutase(SOD),glutathione peroxidase(GSH-Px)and other adverse reactions were responsible.Part ?:Compare two groups of patients with the motor conduction velocity(MNCV)and sensory conduction velocity(SNCV)difference of median nerve and common peroneal nerve.ResultsNo patients were lost to follow-up during the study period.Part I:Effects of liraglutide on blood inflammatory markers,homocysteine and oxidative stress in patients with type 2 diabetic peripheral neuropathy1.Comparison of blood glucose levels between the two groups:before treatment,FPG,2hPG and HbA1c levels showed no statistical difference between the two groups(P>0.05).The levels of FPG,2hPG and HbA1c in the two groups decreased after treatment(P<0.05)compared with that before treatment,but the levels of FPG and HbA1c in the two groups showed no statistical significance(P>0.05),while the levels of 2hPG in the observation group were lower than those in the control group(P<0.05).2.Comparison of blood inflammatory markers between the two groups:before treatment,there was no significant difference in hsCRP,IL-6 and PLR levels between the two groups(P>0.05).After treatment,compared with the two groups before treatment,hsCRP,IL-6 and PLR levels were lower in the observation group than in the control group,and the difference was statistically significant(P<0.05).3.Comparison of plasma Hcy level between the two groups:before treatment,there was no statistical difference in plasma Hcy level between the two groups(P>0.05).After treatment,Hcy level in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).4.Comparison of oxidative stress indicators between the two groups:before treatment,MDA,SOD and GSH-Px levels showed no statistical difference between the two groups(P>0.05).After treatment,compared with the two groups before treatment,MDA levels were significantly decreased,and SOD and GSH-Px levels were significantly increased.MDA levels in the observation group were significantly lower than those in the control group,while SOD and GSH-Px levels were significantly higher than those in the control group,with statistically significant differences(P<0.05).5.Adverse reactions occurred in the two groups:during the 4-week treatment period,no hypoglycemia events and allergic reactions were reported in the observation group and the control group.Twelve patients in the observation group reported mild gastrointestinal reactions,such as nausea,but all subsequently resolved spontaneously.All adverse events did not affect the study process.No patient was exited due to adverse reactions.Part II:Effect of liraglutide on nerve conduction velocity in patients with type 2 diabetic peripheral neuropathy1.Comparison of MNCV between the two groups:before treatment,there was no significant difference in MNCV between the two groups(P>0.05).After treatment,MNCV of median nerve and common peroneal nerve in both groups were significantly accelerated,and the difference was statistically significant(P<0.05).After treatment,MNCV of median nerve and common peroneal nerve in the observation group was significantly faster than that in the control group(P<0.05).2.Comparison of SNCV between the two groups:before treatment,there was no statistically significant difference in SNCV between the two groups(P>0.05).After treatment,SNCV of median nerve and common peroneal nerve in both groups were significantly accelerated,and the difference was statistically significant(P<0.05).After treatment,SNCV of median nerve and common peroneal nerve in the observation group was significantly faster than that in the control group(P<0.05).3.Comparison of clinical efficacy between the two groups:the total clinical effective rate of the observation group was 85.48%after 4 weeks of treatment,which was significantly better than that of the control group(69.35%),and the difference was statistically significant(P<0.05).Conclusion1.Liraglutide has a good sugar lowering effect.At the same level of hypoglycemic effect,compared with the control group,liraglutide can significantly reduce the blood inflammatory markers,homocysteine levels and inhibit oxidative stress in patients with type 2 diabetic peripheral neuropathy.2.Liraglutide can improve the motor and sensory nerve conduction velocity in patients with type 2 diabetic peripheral neuropathy,which may be related to the reduced levels of inflammation and oxidative stress in patients.Liraglutide has a certain clinical effect on type 2 diabetic peripheral neuropathy,and is safe and reliable,worthy of further clinical study. |
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