| Background and ObjectiveDiabetes is a global disease.Type 2 diabetes is the most common type of diabetes,accounting for 90%of all cases of diabetes,and has become a global public health problem.At present,the pathogenesis of T2DM is still not fully elucidated.Multiple studies have shown that T2DM is mainly caused by islet cell dysfunction or insulin resistance,or both.In addition,it was found that the glucagon peptide-1 was reduced in patients with type 2 diabetes[1].GLP-1 is a type of incretin.It can reduce blood glucose by promoting insulin synthesis and secretion,inhibiting glucagon secretion,delaying gastric emptying,and suppressing appetite[2],which is an ideal drug for patients with type 2 diabetes.However,GLP-1 is easily decomposed by DPP-4.Its half-life is only 1-2min,and its degradation product will reduce its affinity with its receptor[3].Therefore,GLP-1 is difficult to be used directly in the treatment of type 2 diabetes.So the study of GLP-1 mainly focused on the research and development of long-acting GLP-1analogues.Two GLP-1 analogues that are currently more commonly used are the Exenatide and Liraglutide.In order to further clarify the efficacy of Liraglutide in patients with type 2 diabetes mellitus and to explore its hypoglycemic mechanism,this experiment was conducted to treat type 2 diabetes mellitus with Liraglutide and metformin.We compared the hypoglycemic effect of the two drugs,provided a broader thought and better evidence for the clinical application of GLP-1 analogues,and improved the quality of life of patients with type 2 diabetes.Subject and Methods1.Subject According to the criteria for the diagnosis of diabetes mellitus formulated by WHO in 1999,100 patients?51 males,49 females?with type 2diabetes mellitus who were first diagnosed or previously ineffective in outpatient or inpatient department of our hospital were selected.2.Grouping Random grouping.Trial group:Liraglutide group,n=50.?26 males,24 females,age 46.93±8.34years,BMI 27.45±1.73 kg/m2?.Control group:metformin group,n=50.?25 males,25 females,age 47.37±8.61years,BMI 27.08±1.46 kg/m2?.3.Observation item Diabetes health education was carried out on the patients with diabetes mellitus.Height,weight,waist circumference and blood pressure were measured and body mass index was calculated.Blood lipid and glycosylated hemoglobin were measured.Fasting and 2-hour glucose levels were monitored by oral glucose tolerance test?OGTT?.The above indexes were measured and measured again at the end of treatment.4.Drug dosageLiraglutide:the initial dosage will be 0.6mg/d,before breakfast,subcutaneous injection.After 1 week,the dosage can be adjusted to 1.2 mg/d.If blood sugar is not well controlled after a month,It can be adjusted to 1.8 mg/d.Metformin:the initial dosage will be 500 mg/d,and the maximum dosage can not be more than 2000 mg/d according to the blood glucose condition.5.Treatment time 12 weeks.6.Follow up The indexes will be measured 12 weeks later.7.Statistics SPSS 20.0 was used to analyze the data.The measurement data are represented by mean±sd?x±s?.Adopt pair T test within groups.Independent-sample T test among groups.The sex composition is tested by?2squared.The test level was0.05.Value will be considered statistically significant at P<0.05.Results1.Comparison of the baselineThere was no significant difference in BMI,waist circumference,blood pressure,blood glucose and blood lipid in the two groups before the trial?P>0.05?.2.Comparison of basic indicatorsAfter 12 weeks,BMI,waist circumference,SBP and DBP of the subjects in the experimental group and control group were lower than before,and the difference was statistically significant?P<0.05?.In trial group,BMI,waistline,SBP and DBP were significantly lower than those in the control group,and the difference was statistically significant?P<0.05?.3.Blood glucose and blood lipidAfter 12 weeks,HbA1c,FPG,2hPG,TG,TC and LDL-C in the trial group and control group were all lower than before,with statistically significant difference?P<0.05?.The HDL-C in the trial group was higher than before,and the difference was statistically significant?P<0.05?.The HDL-C in the control group was higher than before,and the difference was not statistically significant?P>0.05?.HbA1c,2hPG,TG,TC and LDL-C in the trial group were significantly lower than those in the control group,and the HDL-C in the trial group was significantly higher than that in the control group,and the difference was statistically significant?P<0.05?.There was no significant difference in FPG in the trial group compared with the control group?P>0.05?.ConclusionsLiraglutide can reduce FBG,2hBG,Hb A1c,BMI,waist circumference and blood pressure in T2DM patients.And it can improve dyslipidemia in T2DM patients.The risk of hypoglycemia is low in the treatment of Liraglutide.In this trial,we observed that the above effects of Liraglutide was better than those of metformin. |
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