To explore the efficacy of liraglutide combined with dapagliflozin in the treatment of patients with obesity and type 2 diabetes mellitus (T2DM) and its effects on islet function.

A total of 116 patients with obesity and T2DM in Liaocheng People’s Hospital from December 2018 to December 2020 were divided into combined group and control group according to the random number table method, with 58 cases in each group. Both groups were given oral metformin (0.5 g/time, 3 times/d), and received subcutaneous injection of liraglutide before going to bed with an initial dose of 0.6 mg/d which was increased to 1.2 mg/d according to the patients’ response 1 week later. Patients in combined group were additionally treated with oral dapagliflozin (10 mg/time, 1 time/d), and were instructed to eat a reasonable diet and exercise properly, and the two groups were treated for 3 months. The changes of blood glucose, blood lipids, body weight and islet function were compared before and after treatment.

At 3 months of treatment, the levels of fasting plasma glucose (FPG), 2 h postprandial blood glucose (2hPG) and glycosylated hemoglobin (HbA1c) in the two groups were significantly reduced (P<0.05), and the FBG, 2hPG and HbA1c of combined group were lower than those of control group. The body mass index (BMI) and waist-to-hip ratio of the two groups were significantly reduced, and the BMI and waist-to-hip ratio of combined group were lower than those of control group. The levels of serum triglyceride (TG), total cholesterol (TC) and low density lipoprotein-cholesterol (LDL-C) in the two groups were significantly decreased (P<0.05), while the level of serum high density lipoprotein-cholesterol (HDL-C)was significantly increased (P<0.05), and the levels of serum TG, TC and LDL-C in combined group were lower than those in control group while the level of serum HDL-C was higher than that in control group. The fasting insulin (FINS) and islet β cell function index (HOMA-β) of the two groups were significantly increased while the insulin resistance index (HOMA-IR) was significantly decreased, and the FINS and HOMA-β in combined group were higher than those in control group while the HOMA-IR was lower than that in control group (P<0.05). During treatment, the incidence rates of adverse reactions in the two groups were 15.52% and 12.07% (P>0.05).

Liraglutide combined with dapagliflozin in the treatment of patients with obesity and T2DM is beneficial to improve glucolipid metabolism and reduce the body weight of patients. Its mechanism may be related to the improvement of islet function, and short-term treatment has good safety.

Type 2 diabetes mellitus; Obesity; Liraglutide; Dapagliflozin