Abstract:Objective: To compare the effecacy of glucagon-like peptide-1 (GLP1) receptor agonist (liraglutide) and sodium-glucose co-transporters 2 (SGLT2) Efficacy of inhibitors (dapagliflozin) combined with metformin in the treatment of type 2 diabetes,respectively. Methods: From January 2021 to December 2021,120 diabetic patients admitted to our hospital were randomly divided into 3 groups,with 40 cases in each group,as control group (metformin),treatment group A (metformin + liraglutide) ),treatment group B (metformin + dapagliflozin).Automatic biochemical analyzer and enzyme-linked immunosorbent assay (ELISA) were used to detect the blood glucose indexes of patients before and after treatment:fasting blood glucose (FPG),blood glucose 2 hours after meal (2hPBG),glycated hemoglobin (glycosylated hemoglobin,HbA1c),insulin resistance index (insulin resistance index,HOMA-IR) levels,blood lipid indicators triglyceride (triglyceride,TG),total cholesterol (total cholesterol,TC),high-density lipoprotein cholesterol (high density lipoprotein cholesterol,HDL-C),low density lipoprotein cholesterol (low density lipoprotein cholesterol,LDL-C) levels. Results: Compared with before treatment,the levels of FPG,2hPBG,HBA1c and HOMA-IR significantly decreased after treatment (P<0.05),and the TG,TC and LDL-C significantly decreased (P<0.05),HDL-C significantly increased in the three groups of patients after treatment (P<0.05).Compared with the control group,the levels of serum FPG,2hPBG,HBA1c,HOMA-IR and TG significantly decreased in group A and group B after treatment (P<0.05),and TC,LDL-C and HDL-C had no significant difference in group A and group B after treatment (P>0.05).Compared with group A,the levels of FPG and 2hPBG significantly decreased (P>0.05),while the levels of HBA1c,HOMA-IR,TG,TC and LDL-C decreased,with no significant difference in group B (P>0.05).The adverse reaction rates of the three groups were 27.5%,27.5% and 25%,respectively. Conclusion: The SGLT2 inhibitor combined with metformin in reducing blood sugar and lipid-lowering in type 2 diabetes was superior to GLP1 receptor agonist combined with metformin.
朱瑾英, 王尚农, 刘泮力. GLP1受体激动剂和SGLT2抑制剂分别联合二甲双胍治疗2型糖尿病的疗效对比[J]. 河北医学, 2022, 28(7): 1213-1218.
ZHU Jinying, WANG Shangnong, LIU Panli. Comparison of the Efficacy of GLP1 Receptor Agonist and SGLT2 Inhibitor in Respective Combination with Metformin in Treatment of Type 2 Diabetes. HeBei Med, 2022, 28(7): 1213-1218.
[1] Sacerdote A,Dave P,Lokshin V,et al.Type 2 diabetes mellitus,insulin resistance,and vitamin D[J].Curr Diab Rep,2019,19(10):101. [2] Bailey CJ.Metformin:historical overview[J].Diabetologia,2017,60(9):1566-1576. [3] Flory J,Lipska K.Metformin in 2019[J].JAMA,2019,321(19):1926-1927. [4] Glovaci D,Fan W,Wong ND.Epidemiology of diabetes mellitus and cardiovascular disease[J].Curr Cardiol Rep,2019,21(4):21. [5] Wilcox T,De Block C,Schwartzbard AZ,et al.Diabetic agents,from metformin to SGLT2 inhibitors and GLP1 receptor agonists:JACC focus seminar[J].Am Coll Cardiol,2020,75(16):1956-1974. [6] Hostalek U,Campbell I.Metformin for diabetes prevention:update of the evidence base[J].Curr Med Res Opin,2021,37(10):1705-1717. [7] Luo F,Das A,Chen J,Wu P,Li X,Fang Z.Metformin in patients with and without diabetes:a paradigm shift in cardiovascular disease management[J].Cardiovasc Diabetol,2019,18(1):54. [8] Sanchez-Rangel E,Inzucchi SE.Metformin:clinical use in type 2 diabetes[J].Diabetologia,2017,60(9):1586-1593. [9] Marsico F,Paolillo S,Gargiulo P,et al.Effects of glucagon-like peptide-1 receptor agonists on major cardiovascular events in patients with type 2 diabetes mellitus with or without established cardiovascular disease:a meta-analysis of randomized controlled trials[J].Eur Heart,2020,41(35):3346-3358. [10] Tentolouris A,Vlachakis P,Tzeravini E,et al.SGLT2 inhibitors:a review of their antidiabetic and cardioprotective effects[J].Int Environ Res Public Health,2019,16(16):2965. [11] Bailey CJ.Uric acid and the cardio-renal effects of SGLT2 inhibitors[J].Diabetes Obes Metab,2019,21(6):1291-1298. [12] Rodolfo GM,Sara SSL,Mildred AC,et al.The combination of linagliptin,metformin and lifestyle modification to prevent type 2 diabetes (PRELLIM).A randomized clinical trial[J].Metabolism,2020,104(3):154054. [13] Korbut AI,Taskaeva IS,Bgatova NP,et al.SGLT2 inhibitor empagliflozin and DPP4 inhibitor linagliptin reactivate glomerular autophagy in db/db mice,a model of type 2 diabetes[J].Int Mol Sci,2020,21(8):2987. [14] Zelniker TA,Wiviott SD,Raz I,et al.Comparison of the effects of glucagon-like peptide receptor agonists and sodium-glucose cotransporter 2 inhibitors for prevention of major adverse cardiovascular and renal outcomes in type 2 diabetes mellitus[J].Circulation,2019,139(17):2022-2031. [15] Escobar C,Barrios V,Cosin J,et al.SGLT2 inhibitors and GLP1 agonists administered without metformin compared to other glucose-lowering drugs in patients with type 2 diabetes mellitus to prevent cardiovascular events:a systematic review[J].Diabet Med,2021,38(3):e14502. [16] 钟斌理,张岩.达格列净联合利拉鲁肽治疗2型糖尿病合并慢性心力衰竭患者90例[J].中国基层医药,2022,29(1):73-76.