Clinical effects of Metformin combined with a Glucagon-like peptide-1 analogue on type 2 diabetes in elderly patients / 中华老年医学杂志

ABSTRACT

Objective:To investigate the therapeutic effects of Metformin combined with a glucagon-like peptide-1(GLP-1)analogue on type 2 diabetes mellitus and immune cell function in elderly patients.Methods:A total of 180 elderly obese patients with type 2 diabetes mellitus treated in our hospital from November 2018 to November 2020 were included.They were divided into the control group(n=90, treated with Metformin)and the observation group(n=90, taking the GLP-1 analogue liraglutide in addition to Metformin). The two groups of patients were compared on body mass index(BMI), waist-to-hip ratio, glycosylated hemoglobin(HbA1c), fasting blood glucose(FBG), 2 hour postprandial blood glucose(2h-PBG), triglycerides(TG), total cholesterol(TC), high density lipoprotein cholesterol(HDL-C)and islet cell function(homeostatic model assessment of β-cell function, HOMA-β).Results:After treatment, BMI and waist-to-hip ratio decreased more significantly in the observation group than in the control group( P<0.05). HbA1c, FBG and 2H PBG levels were lower in the observation group than in the control group after treatment[(8.81±1.48)% vs.(10.6±1.94)%, (5.54±1.03)mmol/L vs.(6.91±1.10)mmol/L, (7.13±1.27)mmol/L vs.(8.86±1.74)mmol/L, all P<0.05]. After treatment, the observation group had more significantly decreased TG and TC levels and increased HDL-C levels than the control group( P<0.05). Changes in HOMAIR and HOMA-β in the observation group were more evident than in the control group after treatment( P<0.05). The incidence of adverse reactions during treatment was significantly lower in the observation group than in the control group(11.1% vs.31.1%, P<0.05). Conclusions:Metformin combined with a GLP-1 analogue has clearly favorable effects on T 2DM in elderly patients with obesity, helps achieve good blood glucose control and is very safe to use.The combination therapy can significantly restore the function of islet cells in patients with diabetes and delay the progression of diabetes.