新诊2型糖尿病患者短期强化降糖序贯GLP-1的随访研究

摘要

目的 探究短期强化降糖序贯GLP-1 治疗模式对新诊2 型糖尿病 (T2DM) 患者的远期疗效.方法通过对50 例新诊T2DM 患者短期强化降糖, 使血糖达标 (FPG＜6. 1 mmol/L, 2hPG＜8. 0 mmol/L) 后, 给予饮食运动或利拉鲁肽干预, 随访1 年, 比较干预前后血糖缓解率、病情缓解时间及胰岛B 细胞第一时相分泌的变化.结果 饮食运动组血糖缓解率为52. 38％, 病情缓解时间为 (72. 30 ± 52. 23) d, 干预前、随访1 年后的胰岛B细胞第一时相分泌曲线下面积AUCIns0 ～ 10 min为 (274. 11 ± 134. 83) 、 (297. 87 ± 123. 38) mU·min/L (P ＞ 0. 05), AUCCp0 ～ 10 min为 (21. 45 ± 7. 66) 、 (23. 21 ± 7. 84) ng·min/mL (P＜0. 05).利拉鲁肽组血糖缓解率为56. 00％, 病情缓解时间为 (71. 91 ± 47. 12) d, 干预前、随访1 年后的胰岛B 细胞第一时相分泌曲线下面积AUCIns0 ～ 10 min为 (299. 00 ± 132. 16) 、 (317. 22 ± 107. 91) mU·min/L (P ＞ 0. 05), AUCCp0 ～ 10 min为 (21. 87 ± 7. 76) 、 (23. 65 ± 7. 02) ng·min/mL (P＜0. 05).结论 GLP-1 干预可提高新诊T2DM 患者的血糖缓解率, 延长病情缓解时间, 改善胰岛 B 细胞第一时相分泌功能, 但这种效应随着GLP-1 的停用而消退.%Objective To investigate the long-term therapeutic effects of short-term intensive glycemic control sequential therapy of GLP-1 on patients newly diagnosed with type 2 diabetes mellitus (T2DM). Methods Fifty newly diagnosed T2DM patients were treated with short-term intensive glycemic control in order to reach the standard level (FPG＜6. 1 mmol/L, 2hPG＜8. 0 mmol/L), and then they were given diet and exercise (control group) or liraglutide (liraglutide group) for intervention. One-year follow-up was carried out. The rate and time of glucose remission and the first phase secretion of pancreatic β-cell function were compared before and after intervention. Results The glucose remission rate was 52. 38％ in control group; the duration of relief was (72. 30 ± 52. 23) d; the first phase secretion of islet β-cell function area under the curve intervention and after 1-year follow-up was: AUCIns0 ～ 10 min (274. 11 ± 134. 83) mU·min/L vs. (297. 87 ± 123. 38) mU·min/L (P ＞ 0. 05), AUCCp0 ～ 10 min (21. 45 ± 7. 66) ng·min/mL vs. (23. 21 ±7. 84) ng·min/mL (P＜0. 05). The glucose remission rate was 56. 00％ in liraglutide group; the duration of relief was (71. 91 ± 47. 12) d; the first phase secretion of pancreatic β-cell function area under the curve before intervention and after 1-year follow-up was: AUCIns0 ～ 10 min (299. 00 ± 132. 16) mU·min/L vs. (317. 22 ± 107. 91) mU·min/L (P ＞0. 05), AUCCp0 ～ 10 min (21. 87 ± 7. 76) ng·min/mL vs. (23. 65 ± 7. 02) ng·min/mL (P＜0. 05). Conclusion GLP-1 can increase the glucose remission rate and prolong the time of symptom relief, and improve the first phase secretion of pancreatic β-cell function, but the effects disappear gradually with the drug withdrawal.