Comparison Of The Efficacy Of Daglitazine And Pioglitazone Combined With Metformin In The Treatment Of Type 2 Diabetes Mellitus With Non-alcoholic Fatty Liver

Objective:To compare the efficacy of daglitazine or pioglitazone combined with metformin in the treatment of type 2 diabetes mellitus(T2DM)and non-alcoholic fatty liver(NAFLD).Methods:Two hundred and ten patients with T2 DM and NAFLD were randomly divided into pioglitazone group and dapagliflozin group.On the basis of lifestyle intervention,the two groups were given pioglitazone(30mg qd,po)or daglitazine(10mg qd,po)and metformin(500mg tid,po).After 24 weeks of treatment,the patient's physical signs,blood glucose and lipid levels,liver function,CT liver and spleen density ratio and visceral fat content were observed.The efficacy of fatty liver was evaluated and the adverse drug reactions were recorded.Results:A total of 204 patients completed the experiment.Except for the history of drinking,there was no significant difference in the baseline value between the two groups(P>0.05).After 24 weeks treatment,visceral fat area,glycosylated hemoglobin(Hb A1c),insulin resistance index(HOMA-IR),glutamic pyruvic transaminase(ALT),glutamyl transpeptidase(GGT),total cholesterol(TC),total triglyceride(TG)and low density lipoprotein cholesterol(LDL-C)decreased,while high density lipoprotein cholesterol(HDL-C)and CT liver and spleen density ratio increased in both groups(P<0.05).The changes in the dapagliflozin group were more significant than those in the pioglitazone group(P<0.05).There was no significant change in waist-to-hip ratio and BMI in the pioglitazone group(P>0.05).While the waist-hip ratio and BMI in dapagliflozin group were significantly lower than those before treatment(P<0.05).There were no significant difference in adverse reaction rate between the two groups(2.9% vs.2.0%,P>0.05).Conclusion:For patients with T2 DM complicated with NAFLD,the improvement effect of metformin combined with metformin and lifestyle intervention on metabolism and fatty liver was better than that of pioglitazone combined with metformin and lifestyle intervention,and there are no serious adverse reactions in the course of treatment,so it is a safe and effective priority choice for such patients.