Volume 15 · Issue Z1 · 2023

A patient with type 2 diabetes mellitus (T2DM) diagnosed and treated in the Department of Endocrinology of the Second Affiliated Hospital of Baotou Medical College, who was treated with premixed insulin with poor blood glucose control, was converted to insulin deglutide liraglutide injection and achieved good results. The patient was a 71-year-old woman who was admitted to the hospital for 12 years of elevated blood sugar, 3 years of blurred vision and 1 month of numbness in her right hand. He weighed 84 kg, had a body mass index (BMI) of 32.8 kg/m², and was obese. Fasting blood glucose 10.61 mmol/L, 2h postprandial blood glucose 24.8 mmol/L, glycosylated hemoglobin 12.0%, diagnosis of T2DM, diabetic retinopathy. After admission, protamin recombinant human insulin 30R was injected subcutaneously 16 U before breakfast and 14 U before dinner, combined with metformin 0.5 g (twice/d) and dapagliflozin 10 mg (once/d), but the effect was not good. The patient's blood glucose was gradually controlled and stabilized, fasting blood glucose was maintained at 6.3~8.7 mmol/L, blood glucose was maintained at 6.5~10.5 mmol/L 2 h after meal, and insulin degluc liraglutide injection was 16 dose units (1 dose/d). The patient was discharged. At 1 month follow-up after discharge, the patient lost 3 kg of body weight and was free of hypoglycemia and significant adverse gastrointestinal reactions.

Three patients with type 2 diabetes mellitus (T2DM) treated in the Department of Endocrinology of the Fourth Hospital of Daqing City, Heilongjiang Province were reported. The treatment effect of oral hypoglycemic drugs was not good, and the course of treatment was adjusted to insulin degluc liraglutide injection alone or combined. All three patients were male, aged 47, 56, and 61 years. Three cases were treated with oral hypoglycemic drugs (Case 1 with metformin sustained-release tablets alone, Case 2 with metformin sustained-release tablets combined with glimepiride, Case 3 with sitagliptin metformin tablets) for more than 3 months with glycosylated hemoglobin ≥7.0%, and all three cases were complicated with hypertension, dyslipidemia and obesity. The results of post-admission assessment showed that the patient's fasting blood glucose and 2 h post-glucose loading were both high, and the islet function was acceptable, which required weight management, so initiation of injection therapy was considered. Treatment with insulin deglutide liraglutide injection and/or metformin extended-release tablets 1.0 g (twice/d) or dapagliflozin 10 mg (once/d). Follow-up after 3 months showed that the patient had good glycemic control and weight loss.

Two patients with type 2 diabetes mellitus (T2DM) treated in the Department of Endocrinology, Shenyang Fourth People's Hospital of China Medical University were treated with insulin glargine poor glycemic control and insulin deglutide injection, which achieved good results. Both patients were middle-aged and elderly patients with T2DM, with a medical history of 15 and 18 years, respectively, and chronic complications. Before the treatment of long-acting insulin combined with oral hypoglycemic drugs, blood glucose could not be well controlled, and glycosylated hemoglobin was significantly increased (10.6% and 11.2%, respectively). The patient was treated with insulin degluco liraglutide injection combined with dapagliflozin 10 mg (once/d), pioglitazone and metformin 1 tablet each time (twice/d) /metformin 1 000 mg (twice/d), and the dose of insulin degluco liraglutide injection was adjusted according to the blood glucose level. The patient was discharged from hospital with satisfactory blood glucose control and no obvious adverse reactions.

Two patients with type 2 diabetes mellitus (T2DM) treated in the Department of Endocrinology of Bethune Second Hospital of Jilin University were reported. Good results were achieved by adjusting from basal insulin combined with oral hypoglycemic drugs to insulin deglutide injection. Both patients were adult T2DM patients with poor blood glucose control (8.9% and 9.5% glycosylated hemoglobin, respectively) with basal insulin combined with oral hypoglycemic drugs. The course of disease was about 10 years, with poor islet function, hyperlipidemia, overweight or abdominal obesity. Combined with the patient's personal wishes, after switching to insulin deglucide liraglutide injection combined with oral drug hypoglycemic therapy, the blood glucose improved in a short time and continued to reach the standard (<7 mmol/L), body weight and waist circumference decreased to varying degrees, no gastrointestinal adverse reactions and hypoglycemia events, and the tolerance and safety were good.

A patient with type 2 diabetes mellitus (T2DM) treated in the Department of Endocrinology of Suqian Hospital affiliated to Xuzhou Medical University was treated with insulin deglutide liraglutide injection on the basis of oral hypoglycemic drugs. The patient was a 48-year-old male, who was admitted to the hospital mainly for more than 9 months of blood sugar increase, dry mouth and polydipsia for more than 3 months. The patient weighed 95 kg with a body mass index of 29.98 kg/m², waist circumference 102 cm, body type obese. Urinary glucose 3+, urinary ketone body negative. Glucose was 11.13 mmol/L, glycated hemoglobin was 10.7%, and islet cell antibody, insulin antibody and glutamate decarboxylase antibody were all negative. Combined with the medical history and examination results, the patient was diagnosed with T2DM. Treatment with metformin 0.5 g (3 times/d), dapagliflozin 10 mg (1 time/d), increased insulin deglutide liraglutide injection 10 dose units (1 time/d) subcutaneously on day 3 of hospitalization, and increased the dose to 12 dose units (1 time/d) on day 4 of hospitalization, and discontinued dapagliflozin 10 mg (1 time/d). The patient's blood glucose gradually decreased, and the final regimen was oral metformin 0.25 g (3 times/d) combined with insulin degluc liraglutide injection 10 dose units (1 time/d), and the patient was discharged. The patient experienced no gastrointestinal discomfort and no hypoglycemic events during medication. Two weeks and two months after discharge, the patient's blood glucose control was satisfactory, and after two months of discharge, the patient's waist circumference was reduced by 2 cm and his body weight was reduced by 2 kg.

A patient with type 2 diabetes who was treated in the Department of Endocrinology of Huadu District People's Hospital of Guangzhou was treated with short-term intensive insulin therapy and converted to insulin deglutide liraglutide injection combined with acarbose, metformin and dapagliflozin was reported. The patient was a 39-year-old woman diagnosed with diabetes 9 months ago in an external hospital. Body mass index (BMI) 27.69 kg/m², waist 86.3 cm. Glycosylated hemoglobin (HbA_1c) 14.0%, intravenous fasting blood glucose 12.98 mmol/L, 2-h blood glucose 16.15 mmol/L. The fasting C-peptide was 1.70 μ g/L, the C-peptide was 2.45 μ g/L 1 h after glucose loading, and the C-peptide was 2.76 μ g/L 2 h after glucose loading. Insulin-related antibodies were all negative. The patient was diagnosed with T2DM with multiple complications (peripheral neuropathy, diabetic dermatosis, diabetic retinopathy). After 5 days of intensive insulin therapy after admission, the insulin dose was adjusted to insulin detemir 20 U (once/d), insulin aspart (14 U before breakfast, 12 U before lunch, and 12 U before dinner), combined with acarbose 50 mg (three times/d), dapagliflozin 10 mg (once/d), and metformin 0.5 g (three times/d), but the patient's blood glucose was still not controlled up to standard. Insulin detemir was converted to insulin degluc liraglutide injection (starting 16 dose units, once/d) treatment, and short-acting insulin was gradually discontinued in combination with the original oral drug. Fasting blood glucose at discharge was 6.5 mmol/L, and blood glucose at 2 h postprandial was 10.6 mmol/L. At 1 month of follow-up, the dose of insulin degluc liraglutide injection was adjusted to 22 dose units (1 dose/d), and other oral hypoglycemic drugs were maintained unchanged. Blood glucose was gradually controlled and stable, and the time of glucose within the target range reached 78.9% ~97.8% in the second week of discharge. Patient follow-up after 3 months, HbA_1c6.8%, fasting blood glucose 5.1 mmol/L, 2 h postprandial blood glucose 8.4 mmol/L, weight loss 3 kg, waist circumference decrease 2.3 cm. The patient had no symptoms of hypoglycemia and no obvious digestive tract adverse reactions.

This paper reports the diagnosis and treatment of a patient with type 2 diabetes mellitus (T2DM) who was treated with oral hypoglycemic drugs for poor blood glucose control and converted to insulin deglutide liraglutide injection in the Department of Endocrinology of Xingning People's Hospital of Guangdong Province. The patient was a 54-year-old male. He was admitted to the hospital for 5 years of blood sugar increase, fatigue and dry mouth for 1 month. He was diagnosed with T2DM 5 years ago. He was treated with oral hypoglycemic drugs for a long time and had poor blood sugar control. After admission, all examinations were completed, and intensive insulin pump therapy combined with metformin 0.5 g (twice/d) oral hypoglycemic treatment was given. The treatment plan was gradually simplified to insulin deglutide liraglutide injection 18 dose units (once/d) combined with metformin treatment, and blood sugar control was satisfactory and discharged. There were no obvious adverse gastrointestinal reactions during the treatment, and there was one episode of hypoglycemia. The patient's compliance with treatment was good. After 1 or 3 months of discharge, the glycosylated hemoglobin was 6.5%, and the weight loss was about 2 kg. The metabolic indexes of the patient were significantly improved compared with those at the time of admission.

Two adult patients with type 2 diabetes mellitus (T2DM) were treated in the Department of Endocrinology of the First Hospital of Qinhuangdao City, Hebei Province. Both patients were treated with basal insulin combined with prandial insulin or oral hypoglycemic drugs for poor blood glucose control (glycosylated hemoglobin was 8.1% and 8.6%, respectively). The course of the disease was 9 and 12 years, respectively, and they were complicated with metabolic syndrome such as hypertension, fatty liver, hyperlipidemia, hyperuricemia and abdominal obesity. One case was complicated with coronary heart disease and atherosclerosis of carotid artery and lower limb arteries, and complicated with diabetic peripheral neuropathy. After the treatment regimen was translated into insulin deglucin liraglutide injection combined with oral hypoglycemic drug (empagliflozin 10 mg, once/d), fasting and postprandial blood glucose were well controlled and maintained in a short time, body weight and waist circumference were reduced, and no hypoglycemia and adverse gastrointestinal reactions occurred.

Two patients with type 2 diabetes mellitus (T2DM) who were admitted to the Department of Endocrinology of the Fourth Affiliated Hospital of China Medical University were reported. After short-term intensive insulin therapy, they were converted to insulin deglutide liraglutide injection combined with oral drug therapy and achieved good results. All patients were male, and fasting blood glucose ≥7 mmol/L, random blood glucose ≥11.1 mmol/L, glycosylated hemoglobin (HbA_1c) were 11.5% and 8.8%, respectively, meeting the diagnostic criteria for T2DM. There was hyperglycemia at the time of admission, and the blood glucose fluctuated greatly. All patients were given subcutaneous injection of insulin 4 times a day, combined with oral hypoglycemic drugs for intensive treatment. The dosage of insulin and oral hypoglycemic drugs was gradually adjusted, and the blood glucose of the patients was improved. When the fasting blood glucose was 4~6 mmol/L, insulin degu liraglutide injection was injected subcutaneously once a day, combined with one or two oral hypoglycemic drugs. Both patients started with 16 dose units with adjusted final HbA_1cAll of them reached below 7%, the fasting and postprandial blood glucose were well controlled, and there was no hypoglycemia, no extra weight gain, and no gastrointestinal reaction during the medication period. The two had good compliance and tolerance, and the overall hypoglycemic effect was good.

A newly diagnosed type 2 diabetes mellitus (T2DM) patient in the Department of Internal Medicine, Hexiwu Hospital, Wuqing District, Tianjin, was treated with insulin deglutide liraglutide injection combined with oral medication and achieved good results. The patient was a 36-year-old male, mainly due to dry mouth, poly-drinking and weight loss for half a year, aggravated for 3 days. The body mass index (BMI) was 28.1 kg/m after admission², waist circumference 105 cm, body type obese. Laboratory tests revealed 3+ urine glucose and negative ketone bodies. Fasting blood glucose 18.2 mmol/L, glycated hemoglobin (HbA_1c）14.6%。 The diagnosis was T2DM, mixed hyperlipidemia. Insulin deglucide liraglutide injection was given 12 dose units (once/d), subcutaneously injected before breakfast, combined with metformin 500 mg (twice/d) and dapagliflozin 10 mg (once/d), with a diabetic diet prescription. Blood glucose was monitored continuously for 1 week. On the 4th day of treatment, insulin deglutide liraglutide injection was increased from 12 dose units to 14 dose units. Blood glucose gradually decreased to normal, and no hypoglycemia occurred during this period. Follow-up after 2 weeks, fasting blood glucose was 6.9 mmol/L, 2 h postprandial blood glucose was 8.7 mmol/L, body weight decreased by 1.4 kg, insulin deglutide liraglutide injection increased to 16 dose units (once/d), and the patient was satisfied with the treatment effect.