Clinical Efficacy and Safety of Liraglutide and Dapagliflozin on Glucose and Lipid Metabolism and Insulin Function in Patients with Type 2 Diabetes Mellitus.

OBJECTIVE: Observe the changes in clinical indicators of patients with early diabetic nephropathy treated with liraglutide or dapagliflozin, evaluate their clinical efficacy, and provide new ideas for the treatment of diabetic patients. METHODS: In this study, from January 2020 to January 2022, a total of 120 patients with early-stage type 2 diabetic nephropathy who met the inclusion criteria were selected. According to the order of treatment, the patients were randomly divided into traditional group, liraglutide group and dapagliflozin group, with 40 cases in each group. All patients continued their previous conventional hypoglycemic treatment, and the traditional group did not need to adjust the treatment plan; the liraglutide group: added liraglutide (average dose was 1.2 mg daily); the dapagliflozin group: added dapagliflozin (average dose was 10 mg daily). At the same time, all patients received dietary guidance and appropriate exercise intervention for a total of 12 weeks. The changes in blood sugar, blood lipids, pancreatic islet function, liver function, weight, body mass index (BMI) and other indicators before and after treatment were compared, and the adverse reactions that occurred during the medication of the three groups of patients were recorded. Standard doses of liraglutide and dapagliflozin were used in the treatment groups, 0.6 mg daily and 10 mg daily, respectively. These standard doses have been shown to be effective in a wide range of clinical practices and were therefore chosen in this study to ensure consistency and comparability. This helps readers better understand the study methods and results to evaluate these specific dosing options. RESULTS: Prior to treatment, there were no significant differences in the general data and indicators among the three groups, including FPG, 2hPG, HbA1c, TC, TG, HDL-C, LDL-C, ALT, AST, HOMA-IR, FINS, and HOMA-β (all P > .05). In the conventional group, significant changes were observed in FPG, 2hPG, HbA1c, body weight, BMI, HDL-C, LDL-C, ALT, AST, HOMA-IR, FINS, and HOMA-β compared to the pre-treatment period, and these differences were statistically significant (all P < .05).Both the liraglutide and dagliflozin groups exhibited significant changes in FPG, 2hPG, HbA1c, TC, TG, LDL-C, HOMA-IR, FINS, HOMA-β, body weight, BMI, HDL-C, ALT, and AST when compared to the post-treatment period, and these changes were statistically significant (all P < .05). Post-treatment analysis revealed that in terms of blood glucose, FPG, 2hPG, and HbA1c decreased more significantly in the liraglutide and dagliflozin groups compared to the conventional group (all P < .05). Regarding lipids, TC, TG, and LDL-C decreased more significantly in the liraglutide and dagliflozin groups compared to the conventional group (all P < .05). For pancreatic islet function, HOMA-IR and HOMA-β decreased more significantly compared to the conventional group (all P < .05). Weight and BMI decreased more significantly in the liraglutide and dagliflozin groups compared to the conventional group (all P < .05). However, there were no significant differences in hepatic function among the three groups after treatment.Post-treatment comparisons between the liraglutide and dagliflozin groups revealed significant differences in FPG, HbA1c, body weight, and BMI (all P < .05). No adverse events occurred during the treatment period in any of the three groups, and there were no reported deaths. CONCLUSION: The addition of liraglutide or dagliflozin to conventional hypoglycaemic drug therapy in early diabetic patients can not only bring blood glucose to a safe and faster standard, but also regulate blood lipids and glucose, and the therapeutic effect of liraglutide is obvious than that of dagliflozin in terms of blood glucose regulation. Study limitations include small sample size, short study duration, unspecified exclusion criteria, unclear randomization method, and the impact of patient compliance.