Rearch Of Liraglutide In Clinical Practice

Objectives: With advances in improving the quality of life of our people and medicine, the number of people diagnosed with diabetes and pre-diabetes is increasing year by year. In addition to hyperglycemia, its complications much further reduce the quality of life of patients and even increased mortality in patients. Therefore, the prevention and control of diabetes in China has been given great attention and the diabetes listed as one of the national focus on disease prevention and control. Has been a major challenge in the treatment of diabetes is well controlled blood glucose while reducing the side effects of medicine, such as hypoglycemia, weight gain, cardiovascular accidents and so on. Liraglutide is a glucagon like peptide(GLP-1) analogs, due to modificat- ions in the structure, make it from the half-life by natural 1-2minutes to 1-13 hours, which causes it to be once daily administration. Native human GLP-1 in vivo is secreted by the distal small intestine and colon L cells, is a polypeptide containing 30 amino acids, it would need to go through enzymatic hydrolysis to amidate the C-terminal and to remove the N-terminal peptide of 6 to generate the GLP-1(7-36) play a role,which has high activity. Activated glp-1 is mainly degraded into no biologically active glp-1(9-36) and loses its effect by dipeptidyl peptidas(DPP- Ⅳ). GLP-1 is mainly exert biological effects through G protein-coupled receptor-mediated signal transduction pathway, which receptors are present in αβcells, lung, kidney, heart, brain and gastrointestinal tract. Therefore, liraglutide in lowering blood glucose and body weight at the same time it the most common adverse reactions are gastrointestinal discomfort, such as nausea, vomiting and so on, generally occurs in the first few weeks of treatment, but usually mild and transient. Liraglutide beginning in 2009 was used to supplement the use of drugs in the metformin, sulfonylureas or other drugs not good glycemic control case. Its advantage is that glycemic control without increasing the risk of hypoglycemia, improve islet β-cell function, effectively reduce the patient’s weight and reduce cardiovascular risk factors(such as systolic blood pressure, lipids, etc.). This study analyzes the relationship between the indexes after liraglutide combined with multi-drug using in clinical practice. Observe its effect on glycated hemoglobin and weight, as well as the impact on other related indicators, exploring the pros and cons of using liraglutide in other areas.Methods: Through a hospital case management system and follow-up, we collected from November 2011 to June 2014 using liraglutide in patients with type 2 diabetes-related data and information. We recorded the dosage, experimental time, age, gender, disease duration, occupation, contact information, complications and other basic information. Hb A1 c, UACR, SBP, BMI, T-Chol, TRIG, LDL, HDL, ALT, AST, STB, ALKP, GGT, Ch E changes before and after treatment were observed in patients with medication.Starting dosage liraglutide 0.6mg, daily subcutaneous injection, if not nausea, vomiting and other adverse reactions, or can tolerate, weekly additional 0.6mg, until the maximum tolerated dose in patients(1.2mg or 1.8mg), keep the treatment plan until the patient is exit or readmission. The patient ’s own metf ormi- n, insulin secretagogues, ACEI, ARB, aspirin, statins, fibrates drugs, do not limit the manufacturers, prescribed medication. All collected data were anal- yzed using SPSS13.0 statistical analysis software package, all statistical tests using the two-sided test, P<0.05 was considered statistically significant.Result:1 The index patients had different degrees of improvement after treatment. Hb A1 c [-0.50(-0.95,0.45), P=0.042], BMI [-1.02(-2.60,-0.16), P=0.000], TRIG [-0.54(-1.31,0.31), P=0.002], HDL [0.07(-0.08,0.25), P=0.012], and other indicators were significantly different. T-Chol and STB although there are reduced after treatment, but no significant difference.2 In the present study, the patient’s age, duration of disease, smoking and drinking habits as well as the complications did not affect blood sugar and body weight reduction, showed no correlation.3 Hb A1 c reduction in patients with initial Hb A1 c level has a close relationship with, and was negatively correlated(r=-0.444, P=0.000), but with the other indicators, and not much correlation.4 BMI reduction and initial BMI values are closely related, was negatively correlated(r=-0.441, P=0.000). In addition, the change in BMI was also negatively correlated with ALT and AST.5 Although after the medication Hb A1 c and BMI were reduced, but there is no correlation between the changes in the indicators. Hb A1 c changes and changes in BMI showed no more significant association(r=-0.038, P=0.769).Conclusion:1 Effects of liraglutide on blood glucose and body weight was not affected by age, course of disease, smoking and drinking habits and the complications.2 In the context of different medication, liraglutide can improve mild liver function damage from alcoholic fatty liver and nonalcoholic fatty liver caused. But also can reduce transaminase content in patients with normal liver function.3 Liraglutide can improve renal function in patients.4 The glucose and body weight–reducing effects appear to be mutually independent. Liraglutide can improve at least one aspect.