| Object To observe the change of glucose and lipid metabolism, body composition and insulin sensitivity before and after the cambination treatment of exenatide and lansoprazole in type 2 diabetes mellitus(T2DM) patients, and investigate the effects of lansoprazole on the blood gastrin and oxyntomodulin.Method Fifty-four obese patients with type 2 diabetes were chosen into our study, they were randomly divided into treatment group(n=27) and control group(n=27). After 8 weeks of treatment, the changes in weight, fat contents, blood pressure, fasting blood glucose(FBG), serum lipids, fasting insulin, glycosylated hemoglobin(Hb A1c), insulin resistance index(HOMA-IR), serum gastrin and oxyntomodulin were evaluated.Result 46 patients completed the observation. Compared with the baseline levels, the levels of weight, fat contents, FBG, Hb A1 c, HOMA-IR and systolic pressure significantly decreased after treatment in both two groups(p<0.05). More than 95% of patients with gastrointestinal discomfort caused by exenatide are in remission after treatment. In the treatment group, the levels of serum gastrin was significantly increased[(160.76±8.93) vs(95.30±6.01)ng/L, P < 0.05]; The average of fasting blood glucose[(8.06±2.33) vs(8.51±2.71)mmol/L, P < 0.05] and Hb A1c[(7.79±0.78) vs(7.87±0.81)%, P < 0.05] was significantly lower than that of control group. But the changes of OXM in two groups were insignificant[(244.04±30.03) vs(242.09±26.28)ng/L, P > 0.05]. Correlation regression analysis showed that the decrease of Hb A1 c was associated with the increase of gastrin after combination treatment of exenatide and lansoprazole(r=?0.302,P<0.05).Conclusion Lansoprazole can alleviated gastrointestinal discomfort caused by exenatide in the early stage and reduce the blood glucose levels in T2 DM patients, which may be related with the increase of gastrin, however, the changes of oxyntomodulin in two groups were insignificant. |
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