| Objective:A Study comparing the effects of benaglutide and Liragluride on the efficacy,safety and blood glucose fluctuation in adult type 2 diabetes.Methods:According to the enrollment and exclusion criteria,this study selected 37 adult type 2 diabetic patients who had met metformin as a single drug or metformin combined with sulfonylurea in the treatment of unsatisfactory blood glucose from November 2018 to May 2020 at Dalian Central Hospital Subjects(in line with the 1999 WHO diabetes diagnosis and classification criteria),Hb A1c7.0-12%,no change in glucose-lowering program in the past 3 months.Two weeks after the introduction period,sulfonylurea drugs were discontinued after enrollment,and metformin was maintained at the original dose,and were randomly divided into benaglutide group and liraglutide group.All patients collected age,gender,height,weight,BMI,systolic blood pressure,diastolic blood pressure,heart rate,past history,and medication history at baseline and14 weeks after treatment.Detection of blood glucose,Hb A1 c,blood lipids,liver function,kidney function routine biochemistry.Intravenous glucose tolerance test was performed to detect blood glucose and islet function,and calculate the area under the first and second phase insulin curves AUC1,AUC2,HOMA-IR,HOMA-?.Wear the USMedtronic Mini Med company i Por-2 dynamic blood glucose monitoring,Calculate the average blood glucose level(MBG),standard deviation of blood glucose level(SDBG),average blood glucose fluctuation range(MAGE),maximum blood glucose fluctuation range(LAGE),and the average absolute difference in daily blood glucose(MODD),postprandial blood glucose fluctuation range(PPGE),blood glucose variation coefficient(CV)and time within target range(TIR)through dynamic blood glucose monitoring report management system V3.0.Main efficacy evaluation: Changes in Hb A1 c relative to baseline after 14 weeks of treatment.Secondary efficacy evaluation: 1.The attainment rate of Hb A1c?6.5% after 14 weeks of treatment;2.The attainment rate of Hb A1 c <7% after 14 weeks of treatment;3.Changes in FPG relative to baseline after14 weeks of treatment;4.Changes in 2h PG relative to baseline after 14 weeks of treatment;5.Changes in TIR relative to baseline after 14 weeks of treatment.Safety assessment: the frequency of hypoglycemia and other adverse reactions.Statistical method: SPSS 21.0 software was used for statistical analysis.P<0.05 was considered statistically significant.Results: 1.A total of 37 patients with T2 DM were included in this study,including 2patients in the benaglutide group and 1 patient in the liraglutide group who withdrew halfway due to nausea and vomiting and intolerance of the drug reaction after treatment.A total of 34 patients completed the experiment example.Baseline comparison between the two groups: general data,routine biochemistry,AUC1,AUC2,HOMA-IR,HOMA-?,MBG,SDBG,MAGE,LAGE,MODD,PPGE,CV,TIR no statistically significant difference(P>0.05).2.Compared with before and after treatment in the benaglutide group: after 14 weeks of treatment,body weight,BMI,systolic blood pressure,FPG,2h PG,GA,Hb A1 c,HOMA-IR,MBG,SDBG,MAGE,LAGE,MODD,PPGE,CV were lower than the level before treatment was statistically significant(P<0.05);AUC1,HOMA-? and TIR were higher than the pre-treatment levels,with statistically significant(P<0.05);There were no statistically significant differences in diastolic blood pressure,heart rate,TC,TG,HDL-C,LDL-C,ALT,AST,?-GT,ALP,creatinine,urea nitrogen,uric acid,and AUC2(P>0.05).3.Compared with before and after treatment in the liraglutide group: after 14 weeks of treatment,Body weight,BMI,FPG,2h PG,GA,Hb A1 c,HOMA-IR,MBG,SDBG,MAGE,LAGE,MODD,PPGE,and CV were lower than the pre-treatment levels was statistically significant(P<0.05);AUC1,HOMA-? and TIR were higher than the pre-treatment levels,with statistically significant(P<0.05);systolic blood pressure,diastolic blood pressure,heart rate,TC,TG,HDL-C,LDL-C,ALT,AST,?-GT,ALP,creatinine,urea nitrogen,uric acid,AUC2 were not statistically significant different(P>0.05).4.Primary and secondary efficacy evaluation:After 14 weeks of treatment,compared with baseline,Hb A1 c in the benaglutide group and liraglutide group decreased(-1.85 ± 0.82vs-2.08 ± 1.18),with no statistically significant(P>0.05);Benaglutide group and liraglutide group: The attainment rate of Hb A1c?6.5%(35.3%vs 41.2%),The attainment rate of Hb A1 c <7%(47.1% vs 58.8%),there was no statistically significant(P>0.05);FPG changes relative to baseline(-1.14 ± 0.92 vs-1.74± 1.46),2h PG changes relative to baseline(-2.24 ± 1.87vs-2.46±1.74),There was no statistically significant(P>0.05);Changes in TIR relative to baseline after 14 weeks of treatment:There was no statistically significant in TIR between the benaglutide group and the liraglutide group(26.69 ± 16.02 vs 26.85 ± 17.32)(P>0.05).Safety assessment:There was no statistically significant difference in the frequency of mild hypoglycemia,hypoglycemia symptoms and adverse reaction events of nausea,vomiting,diarrhea and dizziness between the two groups(P>0.05).After 14 weeks of treatment,there were no statistically significant in the blood glucose fluctuation indexes MBG,SDBG,MAGE,LAGE,MODD,PPGE,and CV between the two groups(P>0.05).5.Pearson correlation analysis:MAGE,LAGE,MODD,CV are positively correlated with FPG,2h PG,GA,Hb A1c(r=0.779,P=0.005;r=0.846,P=0.001;r=0.852,P=0.001;r=0.779,P=0.005;r=0.938,P=0.000;r=0.893,P=0.000;r=0.873,P=0.000;r=0.840,P=0.001;r=0.703,P=0.01;r=0.731,P=0.011;r=0.818?P=0.002;r=0.764,P=0.006;r=0.708,P=0.015;r=0.749,P=0.008;r=0.809,P=0.003;r=0.738,P=0.009);Negative correlation between TIR and FPG,2h PG,GA,Hb A1c(r=-0.916,P=0.000;r=-0.950,P=0.000;r=-0.917,P=0.000;r=-0.958,P=0.000).Conclusion: 1.Benaglutide can effectively reduce FPG,2h PG,and Hb A1 c in adult patients with type 2 diabetes,and significantly increase TIR.2.Benaglutide and liraglutide Hb A1 c,FPG,2h PG reduction degree,TIR increase degree,Hb A1 c compliance rate and safety efficacy are similar.3.Blood glucose fluctuations were positively correlated with FPG,2h PG,GA,and Hb A1 c,and TIR was negatively correlated with FPG,2h PG,GA,and Hb A1 c. |
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