摘要
Abstract
Objective To observe the efficacy and safety of semaglutide combined with insulin aspartate 30 in the treatment of elderly type 2 diabetes mellitus(T2DM).Methods Elderly patients with T2DM were divided into treatment group and control group.Control group was given subcutaneous injection of insulin aspartate 30,with initial dose of 0.2 U·kg-1 d-1 and maximum dose not more than 1.5 U·kg-1·d-1;treatment group was given subcutaneous injection of semaglutide on the basis of control group,with initial dose of 0.25 mg a time once a week,the dose was increased to 0.50 mg a time,once a week after 4 infections,and then the dosage was adjusted according to blood glucose monitoring with the maximum dose ≤1.0 mg a week.Glucose metabolism[fasting blood glucose(FBG),2 h postprandial blood glucose(2 h PBG),glycated hemoglobin(HbA1 c)],lipid metabolism[total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)],body mass index(BMI),lipid accumulation index(LAP)and gene expression levels of peripheral blood angiopoietin(Ang)-1,Ang-2 and Annexin A2 were compared between the two groups,and the safety of treatment was evaluated.Results There were 59 cases in treatment group and 63 cases in control group.After 12 weeks of treatment,the FBG levels in treatment group and control group were(6.12±0.81)and(6.49±0.78)mmol·L-1;2 h PBG levels were(8.13±1.63)and(8.94±1.72)mmol·L-1;HbA1c levels were(6.65±0.97)％and(7.21±1.05)％;TC levels were(3.13±0.64)and(3.42±0.72)mmol·L-1;TG levels were(1.76±0.30)and(1.90±0.35)mmol·L-1;LDL-C levels were(2.53±0.48)and(2.72±0.51)mmol·L-1;HDL-C levels were(1.14±0.15)and(1.07±0.16)mmol·L-1;BMI values were(22.79±2.01)and(24.19±2.24)kg·m-2;LAP values were 44.29±5.34 and 54.42±5.08;relative expression levels of peripheral blood AnnexinA2 were 1.60±0.32 and 1.75±0.38;all with significant differences(all P＜0.05).There was no statistically significant difference in the total incidence of adverse drug reactions between the two groups(16.95％vs 6.35％,P＞0.05).Conclusion Semaglutide combined with insulin has significant effects on blood glucose reduction and weight loss and has good safety on elderly patients with T2DM.It can also improve lipid metabolism and inhibit microangiopathy,and it is of high application value as a second-line treatment regimen.关键词
司美格鲁肽注射液/门冬胰岛素30注射液/2型糖尿病/老年/减重Key words
semaglutide injection/insulin aspartate 30 injection/type 2 diabetes mellitus/elderly/weight loss分类
医药卫生
