Efficacy Of Liraglutide In The Treatment Of Type 2 Diabetes Mellitus Complicated With Obstructive Sleep Apnea Hypopnea Syndrome

Objective:To analyze the effects of liraglutide on blood glucose,lipid metabolism,body weight,islet function,and sleep apnea hypopnea index in patients with type 2 diabetes mellitus complicated with obstructive sleep apnea-hypopnea syndrome(OSAHS).Compared with insulin glargine,the clinical application value of liraglutide was discussed.Methods:1.According to the inclusion and exclusion criteria,the outpatient clinic and inpatients in our hospital from January 2017 to September 2018 were selected.The diagnosis was type 2 diabetes with OSAHS.Metformin hydrochloride was used for more than 3 months and blood glucose control was not Eighty patients were enrolled,and the age,sex,course of disease,blood glucose,blood lipids,body weight,islet function index,and sleep apnea hypopnea were recorded.2,patients were randomly divided into two groups,one group with liraglutide(observation group,n=40 cases),one group with insulin glargine(control group,n=40 cases),blood glucose control target for fasting blood glucose(FPG)4.5-7.0 mmol/L,blood glucose(2hPBG)<10.0mmol/L two hours after meal,glycosylated hemoglobin(HbA1C)<7%.After 16 weeks of continuous medication,the patients in the two groups were compared with fasting blood glucose(FBG),postprandial blood glucose(2hPBG),glycosylated hemoglobin(HbA1C),fasting C-peptide(FC-P),fasting insulin(FINS),total Cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),body weight,body mass index(BMI),waist circumference(WC),waist-to-hip ratio(WHR),changes in sleep apnea hypopnea index(AHI),and minimum oxygen saturation(LSa02).Insulin resistance index(HOMA-IR)was calculated by fasting blood glucose(FBG)and fasting insulin(FINS).The clinical treatment effect of the group.Results:1.There was no significant difference in baseline data between the two groups before treatment(P>0.05),which was comparable.2.Comparison of various indexes of glucose metabolism:FBG,2hPBG and HbA1C decreased after treatment in the two groups.The difference was statistically significant(P<0.05).There was no significant difference between the two groups before and after treatment(P>0.05).3.Comparison of various indexes of lipid metabolism:TC,TG and LDL-C decreased after treatment in both groups,and HDL-C increased compared with before treatment.The difference was statistically significant(P<0.05).There was no significant difference in the change of LDL-C before and after treatment(P>0.05).The dregree of TG decline and HDL-C elevation in the observation group were significantly higher than those in the control group(P<0.05).4.Comparison of body weight and other indicators:Body weight,BMI,WC and WHR of the two groups were lower than those before treatment.The observation group was more significant than the control group,and the difference was statistically significant(P<0.05).5.Comparison of sleep apnea indexes:AHI decreased after treatment,and LSA02 increased before treatment.The difference was statistically significant(P<0.05).The decrease of AHI and the increase of LSa02 in the observation group.It was more significant than the control group,and the difference was statistically significant(P<0.05).6.After treatment,the FC-P of the two groups increased after treatment,the difference was statistically significant(P<0.05).The increase of FC-P in the observation group was significantly higher than that of the control group,the difference was statistically significant(P<0.05).HOMA-IR decreased in the observation group compared with that before treatment,and HOMA-IR in the control group increased before treatment,the difference was statistically significant(P<0.05).6.During the follow-up period,no hypoglycemia occurred in the observation group.Fourteen patients developed tolerable gastrointestinal reactions.In the control group,4 hypoglycemia events occurred,and 4 patients could tolerate gastrointestinal reactions.Conclusion:1,Compared with insulin glargine,liraglutide treatment can improve lipid metabolism,body weight and sleep apnea hypopnea in patients with type 2 diabetes and OSAHS.2,liraglutide can improve insulin resistance in patients with type 2 diabetes and OSAHS.