早期将强化胰岛素治疗转换为德谷胰岛素利拉鲁肽在降低2型糖尿病患者空腹血糖和糖化血红蛋白方面显示出更高的疗效和安全性。

Early Conversion of Intensive Insulin Therapy to IDegLira Demonstrates Higher Efficacy and Safety in Reducing Fasting Blood Glucose and HbA1c in T2DM Patients.

作者信息

Guo Caiyun, Lu Yang

机构信息

Department of Endocrinology, YuYao People's Hospital, Ningbo, Zhejiang Province, People's Republic of China.

出版信息

Diabetes Metab Syndr Obes. 2024 Aug 29;17:3217-3226. doi: 10.2147/DMSO.S472174. eCollection 2024.

BACKGROUND

A short-term insulin intensive therapy is an important method used in clinical practice to control blood glucose, and a scientific post-treatment plan is key to long-term blood glucose stability control. This study aimed to investigate efficacy and safety of early conversion of intensive insulin therapy to IDegLira in T2DM patients.

METHODS

This study was a prospective study, involving 80 T2DM patients finally. Patients were firstly treated with insulin for intensified therapy (Pre-IDegLira group), then switched to insulin degludec and liraglutide (IDegLira) for 3 months (IDegLira-3 months group). Data including HbA1c, fasting blood glucose, fasting C-peptide, weight, insulin dosage, total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were analyzed. Correlations between fasting blood glucose and other parameters were evaluated with Pearson correlation analysis.

RESULTS

IDegLira early conversion significantly reduced fasting blood glucose (<0.001), weight (=0.015), and insulin dosage (=0.001) of T2DM patients compared to those of Pre-IDegLira group. HbA1c level was remarkably lower in T2DM patients underwent IDegLira early conversion compared to that in Pre-IDegLira group (<0.001), with HbA1c <7% proportion of 73.75% (59/80). IDegLira early conversion significantly downregulated levels of TC (<0.001), TG (<0.001), LDL-C (<0.001), and upregulated HDL-C level (=0.017) of T2DM patients, compared to those in Pre-IDegLira group. IDegLira early conversion markedly reduced ALT (<0.001) and AST (=0.002) levels of T2DM patients compared to those in Pre-IDegLira group. IDegLira early conversion demonstrated a positive correlation between fasting blood glucose and HbA1c (=0.531, <0.001) or TG level (=0.336, =0.002) in T2DM patients.

CONCLUSION

Early conversion of intensive insulin therapy to IDegLira effectively reduced fasting blood glucose and HbA1c in T2DM patients with higher safety.

背景

短期胰岛素强化治疗是临床实践中用于控制血糖的重要方法，科学的治疗后计划是长期稳定控制血糖的关键。本研究旨在探讨2型糖尿病（T2DM）患者强化胰岛素治疗早期转换为德谷胰岛素利拉鲁肽（IDegLira）的疗效和安全性。

方法

本研究为前瞻性研究，最终纳入80例T2DM患者。患者首先接受胰岛素强化治疗（预IDegLira组），然后转换为德谷胰岛素和利拉鲁肽（IDegLira）治疗3个月（IDegLira - 3个月组）。分析包括糖化血红蛋白（HbA1c）、空腹血糖、空腹C肽、体重、胰岛素剂量、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL - C）、高密度脂蛋白胆固醇（HDL - C）、天冬氨酸转氨酶（AST）和丙氨酸转氨酶（ALT）在内的数据。采用Pearson相关分析评估空腹血糖与其他参数之间的相关性。

结果

与预IDegLira组相比，IDegLira早期转换显著降低了T2DM患者的空腹血糖（<0.001）、体重（=0.015）和胰岛素剂量（=0.001）。接受IDegLira早期转换的T2DM患者的HbA1c水平显著低于预IDegLira组（<0.001），HbA1c<7%的比例为73.75%（59/80）。与预IDegLira组相比，IDegLira早期转换显著下调了T2DM患者的TC（<0.001）、TG（<0.001）、LDL - C（<0.001）水平，并上调了HDL - C水平（=0.017）。与预IDegLira组相比，IDegLira早期转换显著降低了T2DM患者的ALT（<0.001）和AST（=0.002）水平。IDegLira早期转换显示T2DM患者空腹血糖与HbA1c（=0.531，<0.001）或TG水平（=0.336，=0.002）之间呈正相关。