关键词:

2型糖尿病, 高血压, 甘精胰岛素, 司美格鲁肽

Abstract:

Objective　To investigate the efficacy and safety of insulin glargine combined with semaglutide injection in the treatment of type 2 diabetes mellitus (T2DM) patients with poor blood glucose control and hypertension. Methods　One hundred and four T2DM patients with poor blood glucose control and hypertension treated at Jinan Maternal and Child Health Hospital from July 2021 to February 2023 were selected for the randomized controlled trial, and were divided into a control group and a study group by the random number table method, with 52 cases in each group. There were 30 males and 22 females in the control group; they were (48.04±4.03) years old; their body mass index was (24.08±3.15) kg/m²; their duration of T2DM was (5.96±0.74) years; their duration of hypertension was (2.96±0.41) years. There were 28 males and 24 females in the study group; they were (47.13±4.48) years old; their body mass index was (24.14±2.86) kg/m²; their duration of T2DM was (6.13±0.85) years; their duration of hypertension was (3.03±0.38) years. The control group were treated with semaglutide injection, and the study group with insulin glargine and semaglutide injection, for 3 months. The glucose metabolism, islet function, lipid metabolism, and blood pressures before and after the treatment and incidences of adverse drug reactions were compared between the two groups by t and χ² tests. Results　The levels of fasting blood glucose (FBG), 2 h postprandial blood glucose (2hPBG), and glycosylated hemoglobin (HbA1c) and insulin resistance index (HOMA-IR) were lower after than before the treatment in both groups; the levels of FPG, 2hPPG, and HbA1c and HOMA-IR after the treatment in the study group were lower than those in the control group [(5.91±0.76) mmol/L vs. (6.49±0.88) mmol/L, (8.47±0.96) mmol/L vs. (9.58±1.06) mmol/L, (5.27±0.73)% vs. (6.19±0.97)%, and (4.53±0.69) vs. (5.39±0.86); t=3.935, 5.774, 9.724, and 5.624; all P<0.05]. The levels of triglyceride (TG) and total cholesterol (TC) were lower after than before the treatment in both groups; the levels of TG and TC after the treatment in the study group were lower than those in the control group [(2.11±0.31) mmol/L vs. (2.49±0.39) mmol/L and (4.74±0.58) mmol/L vs. (5.29±0.75) mmol/L; t=5.500 and 4.183; both P<0.05]. The levels of low density lipoprotein cholesterol (LDL-C) in both groups after the treatment were lower than those before the treatment (both P<0.05); there was no statistical difference in the level of LDL-C after the treatment between the two groups (P>0.05). There were no statistical differences in the systolic and diastolic blood pressures after the treatment between the control group and the study group [(121.03±14.28) mmHg (1 mmHg=0.133 kPa) vs. (116.81±15.41) mmHg and (84.01±9.62) mmHg vs. (81.98±8.56) mmHg; both P>0.05]. There was no statistical difference in the incidence of adverse drug reactions between the control group and the study group [11.54% (6/52) vs. 13.46% (7/52); P>0.05]. Conclusion　Insulin glargine combined with semaglutide injection for T2DM patients with poor blood glucose control and hypertension can effectively control their glucose and lipid metabolism and improve their function of pancreatic islets, and is safe.

Key words:

Type 2 diabetes mellitus, Hypertension, Insulin glargine, Semaglutide