Effect Of Polyethylene Glycol Losenatide On Glycemic Variability In Overweight And Obese Patients With Primary Diagnosis Of Type 2 Diabetes Mellitus

Objective:In this study,we observed the effects of polyethylene glycol losenatide on clinical indicators and blood glucose fluctuations in overweight and obese patients with primary type 2 diabetes mellitus(T2DM)to provide evidence-based clinical evidence for the treatment of T2DM and improvement of blood glucose profile.Methods:Patients with T2DM who attended the Second Hospital of Jilin University from November 2021 to October 2022 were selected and randomly divided into 60 cases in the pegylated losenatide group and 60 cases in the glargine insulin group by using the random number table method,and all patients were given comprehensive treatment such as diet modification,exercise intervention,medication instruction and health education.In the observation group,on the basis of the original oral medication,polyethylene glycol losenatide was added by subcutaneous injection at a dose of 0.2mg,and subcutaneous abdominal injection was given once a week at a fixed time.In the control group,on top of the original oral medication,recombinant glargine insulin was injected subcutaneously once a night at bedtime,and the insulin dosage was adjusted promptly according to the blood glucose level.Patients in both groups were treated continuously for 12 weeks.The general data,laboratory indexes and glucose variability indexes,including waist circumference,body weight,body mass index(BMI),fasting plasma glucose(FPG),2-hour postprandial glucose(2h PG),glycosylated hemoglobin(Hb A1C),Triglyceride(TG),Total cholesterol(TC),Low density lipoprotein(LDL),High density lipoprotein(HDL),Homeostisis modle assessment-insulin resistance index(HOMA-IR),Fasting C peptide(FCP),Alanine aminotransferase(ALT),Aspartate aminotransferase(AST),Glutamyltransferase(GGT),Time in range(TIR),Time above range(TAR),Time below range(TBR),Mean blood glucose(MBG),Standard deviation of mean blood glucose(SDBG),Coefficient of variation(CV),and Large amplitude of glycemic excursions(LAGE).Results:A total of 120 patients with T2DM were collected in this study,and finally 116 patients adhered to the treatment regimen and completed the follow-up,including 57 patients in the polyethylene glycol losenatide group and 59 patients in the glargine insulin group.There was no significant difference between the two groups in terms of general information,laboratory indexes and glycemic variability indexes before treatment(P>0.05).Waist circumference,weight and BMI were significantly lower in the pegylated losenatide group after 12 weeks of treatment compared with those before treatment(P<0.05),while there was no significant effect on waist circumference,weight and BMI in the glargine insulin group(P>0.05).FPG and Hb A1 C were significantly lower in both groups after 12 weeks of treatment compared with those before treatment(P<0.05).The 2h PG and HOMA-IR were significantly lower in both groups compared with those before treatment(P<0.05),and the decrease was significant in the polyethylene glycol losenatide group compared with the glargine insulin group(P<0.05).FCP was significantly higher in both groups compared with the pre-treatment period(P<0.05),and it increased significantly in the pegylated losenatide group compared with the glargine group(P<0.05).After 12 weeks of treatment,TG was significantly lower in the pegylated losenatide group compared with that before treatment(P<0.05),while there was no significant effect on TG in the glargine insulin group(P>0.05).TC and LDL in both group were significantly lower than before treatment(P<0.05),and the decrease in TC and LDL in the pegylated losenatide group was more significant than that in the glargine insulin group(P<0.05),and there was no significant difference in HDL in both groups compared with before treatment(P>0.05).After 12 weeks of treatment,AST and GGT were significantly lower in the pegylated losenatide group than before treatment(P<0.05),and there was no significant effect on AST and GGT in the glargine insulin group(P>0.05).In both groups,ALT was significantly lower than before treatment(P<0.05),and the decrease was more pronounced in the pegylated losenatide group than in the glargine insulin group(P<0.05).TIR was significantly higher in both groups after 12 weeks of treatment compared with the pre-treatment period(P<0.05),and it rose significantly in the polyethylene glycol losenatide group compared with the glargine insulin group(P<0.05).MBG was significantly lower in both groups compared with that before treatment(P<0.05).TAR,SDBG,CV and LAGE were significantly lower in both groups compared with those before treatment(P<0.05),and decreased significantly in the polyethylene glycol losenatide group compared with the glargine insulin group(P<0.05).There was no significant difference in TBR between the two groups compared with that before treatment(P>0.05).Conclusion:1.Polyethylene glycol losenatide has the same effect as glargine insulin in lowering overall mean blood glucose.However,Polyethylene glycol losenatide can further reduce blood glucose fluctuation,increase TIR,decrease TAR,SDBG,LAGE,CV on the basis of lowering average blood glucose without increasing the risk of hypoglycemia.2.Polyethylene glycol losenatide can reduce body weight,lower FPG,2hPG and HbA1C in T2DM patients.Compared with glargine insulin,polyethylene glycol losenatide has more significant advantages in improving islet function,reducing insulin resistance and regulating blood lipid metabolism.