Effect of GLP-1 analogue combined with metformin on blood glucose control and insulin resistance in obese patients with type 2 diabetes mellitus

Abstract

Objective To study the effects of glucagon-like peptide-1 (GLP-1) analogues combined with metformin on body glycemic control and insulin resistance in patients with type 2 diabetes mellitus (T2DM) . Methods The medical records of 132 patients with obese T2DM who were treated in our hospital from Jan. 2014 to Jun. 2017 were retrospectively analyzed. The patients were divided into observation group and the control group according to the random number table method, 66 cases each. The control group were treated with metformin combined with imimol. The observation group were treated with metformin combined with GLP-1 analogue. The difference of (body mass index, BMI) , (glycosylated hemoglobin, HbA1c) , (fasting blood glucose, FBG) , (2 hour postprandial blood glucose, 2 h PBG) , (triglyceride, TG) , (total cholesterol, TC) , (high density lipoprotein-cholesterol, HDL-C) , (low density lipoprotein-cholesterol, LDL-C) , (fasting insulin, FINS) , (fasting C peptide, FCP) , (homeostatic model assessment of insulin resistance, HOMA-IR) , (homeostatic model assessment-β cell, HOMA-β) between the two groups were compared. Results Statistical analysis showed that there was no significant difference in the pre-treatment related indexes between the two groups (all P>0.05) . The BMI, waist-to-hip ratio of the observation group were more obvious after treatment (P<0.05) . The levels of HbA1c, FBG and 2 h PBG in the observation group and the control group were 6.85±1.49 vs 8.92±1.02 (%) , 5.99±2.09 vs 7.21±3.04 (mmol/L) , 7.90±2.04 vs 9.78±3.47 (mmol/L) (all P<0.05) . The levels of TG, TC and LDL-C in the observation group were significantly lower than those in the control group, and the level of HDL-C was significantly increased (P<0.05) . The level change of FINS (15.08±3.21 vs 11.05±2.8) (mIU/L) , FCP (2.21±0.84 vs 1.84±0.71) (pmol/L) , HOMA-IR (1.33±0.09 vs 2.15±0.12) and HOMA-β (54.29±10.98 vs 32.15±6.43) were more obvious in the observation group than in the control group between before and after treatment (all P<0.05) . The incidence of adverse reactions during the treatment was 3.04% vs 28.79) (P<0.05) . Conclusions GLP-1 analogue combined with metformin is effective in treatment of obese T2DM. The patient’s blood sugar control effect is better, and the safety is higher. The body’s insulin secretion level is increased, the insulin resistance is reduced, and the islet β cell function is obviously restored.It has positive significance in delaying the development of diabetes, thus worthy of clinical promotion. Key words: GLP-1 analogue; Metformin; Obese type 2 diabetes; Blood glucose; Insulin resistance