目的 探讨对于单用二甲双胍血糖控制不理想的2型糖尿病患者给予艾塞那肽联合口服药降糖方案的有效性及安全性。方法 收集60例单用二甲双胍血糖控制不理想的2型糖尿病患者, 随机分为艾塞那肽组和甘精组, 两组均采用二甲双胍常规治疗, 艾塞那肽组加用1 d 1次艾塞那肽, 甘精组加用甘精胰岛素1 d 1次, 随访52周, 观察糖化血红蛋白(HbA1c), 空腹血糖(FPG)、餐后2 h 血糖(2hPG)等有效性指标, 胰岛β细胞功能及体质量指数(BMI), 低血糖发生情况。结果 艾塞那肽组治疗后空腹血糖和糖化血红蛋白相较于甘精组显著下降(P<0.05), 艾塞那肽组△HOMA-13显著高于甘精组(P<0.05), 两治疗组体重的改变有着显著差异(P<0.05)。结论 艾塞那肽可用于长期的血糖控制, 改善胰岛β细胞功能, 低血糖风险低, 降低体重。

OBJECTIVE To observe the effect and safety of exenatide therapy in type 2 diabetes patients with failure to metformin.METHODS Sixty patients with type 2 diabetes who did not achieve satisfactory blood glucose control were randomly assigned either to add exenatide or glargine. postprandial blood glucose, HbA1C, blood lipid, and body mass index of the patients before and after treatment were recorded, and the side effects were also recorded for 52 weeks.RESULTS The FPG and HbA1C of patients decreased more significantly after exenatide therapy than glargine treatment (P<0.05). The exenatide group had a significantly higher level of △HOMA-13 than the glargine group. CONCLUSION Exenatide can be used for long-term control of blood glucose with improving lipid metabolism and low occurrence of hypoglycemia, without increasing body weight.