Comparison of therapeutic effects of hypoglycemic drugs in T2DM patients with different clinical characteristics
ZHENG Yao
ZHOU Yikun
MA Xiaoyue
Abstract：Objective To compare the therapeutic effects of hypoglycemic drugs in type 2 diabetes mellitus(T2DM)patients with different clinical characteristics.Methods A total of 4,911 patients with T2DM were retrospec-tively selected.Based on the K-means clustering method,the patients were classified according to six indicators at base-line:age,disease duration,body mass index(BMI),glycated hemoglobin(HbA1c),homeostasis model assessment of β-cell function index 2(HOMA2-β),and homeostasis model assessment 2-insulin resistance(HOMA2-IR)index.We compared the therapeutic effects of hypoglycemic agents in patients with different types,including the reduction of HbA1c,HbA1c achievement rate,body weight reduction,and body mass index(BMI)achievement rate.Results The results of cluster subtype characteristic analysis showed that 4,911 patients could be classified into 854 cases of obese insu-lin resistance type(type A),1,159 cases of elderly and long-course type(type B),1,069 cases of well-controlled blood glucose type(type C),and 1,829 cases of severe insulin deficiency type(type D).For type A patients,the reduction in HbA1c,the reduction in body weight,and the rate of reaching the HbA1c target in the group using glucagon-like peptide 1 receptor agonist(GLP-1RA)/sodium-glucose cotransporter 2 inhibitor(SGLT-2i)were higher than those in the non-use group(all P<0.05),while there was no statistically significant difference in the rate of reaching the BMI target(P>0.05).For patients with type B,the regimen of oral medication/GLP-1RA plus basal insulin had a higher weight reduction in com-parison with the regimen of adding basal insulin during meals(P<0.05).For patients with type C of using only one oral medication,there were no statistically significant differences in the four indicators between the biguanide group and the non-biguanide group(P>0.05).For type D patients,there were statistically significant differences in the reduction of HbA1c and body weight between the group receiving intensive insulin therapy(with basal insulin added during meals)and the non-treatment group(P<0.05),and no significant difference was found in the other parameters(all P>0.05).Conclusions During clinical diagnosis and treatment,GLP-1RAs or SGLT-2i should be incorporated into the therapeu-tic regimen for patients with T2DM characterized by obesity.For elderly patients with a long disease course,treatment with a single oral hypoglycemic agent/GLP-1RA combined with basal insulin confers higher safety.Patients with well-con-trolled blood glucose should be prioritized for biguanides,while those with poorly controlled blood glucose show favorable responses to intensive insulin therapy.
Keywords：type 2 diabetes mellitusclinical featurescluster analysishypoglycemic drugs
Publication Date：2025-12-25
Online Publishing Date：2026-01-12(First online date of this platform, not the publication date of the document)
Pages：5( 86-90 )