Study on influencing factors for gastrointestinal adverse reactions in diabetic patients with liraglutide and simegallutide

Li Yaran; Zhao Huimin; Zhang Yanqing; Zhang Jian; Tian Xiaopeng

doi:10.3969/j.issn.1672-8157.2025.03.040

Abstract：Objective To explore the influencing factors for gastrointestinal adverse reactions in patients with glucagon-like pep-tide-1 receptor agonist(GLP-1RA)drugs liraglutide and simegallutide for type 2 diabetes mellitus(T2DM).Methods A total of 228 patients with T2DM who were treated in the Department of Endocrinology of Xingtai People's Hospital in Hebei Province from January 2023 to June 2024 were selected as the study subjects,and the gastrointestinal adverse reactions of the patients were observed and re-corded during the treatment with liraglutide and simethicone,and patients were divided into the gastrointestinal adverse reaction group and the non-gastrointestinal adverse reaction group according to whether or not they had gastrointestinal adverse reactions.The differ-ences in the clinical data between the two groups were compared,and the influencing factors affecting the gastrointestinal adverse reac-tions of T2DM patients were analyzed using Logistic regression analysis equation.Results A total of 75 patients(32.89%)described the presence of gastrointestinal adverse reactions during the medication period,and the total number of occurrences was 245 case-times.The highest number of nausea occurred in 93 case-times(37.96%),followed by 50 case-times of diarrhea(20.41%),46 case-times of vomiting(18.78%),and 37 case-times of abdominal discomfort(15.10%),and the lowest number of constipation occurred in 19 case-times(7.76%).There were no statistically significant differences in the frequency and severity of gastrointestinal adverse reactions between the patients treated with liraglutide and those treated with semaglutide(P>0.05).The proportion of female patients,age,BMI,duration of T2DM,dose of GLP-1RA,percentage of history of gastrointestinal disease,and number of other medications taken in com-bination were higher in the gastrointestinal ADR group than in the non-gastrointestinal ADR group,and diastolic blood pressure(DBP),free triiodothyronine(FT3),free thyroxin(FT4),alanine aminotransferase(ALT),estimated glomerular filtration rate(eGFR),total bili-rubin(TBIL),and uric acid(UA)were lower than those in the non-gastrointestinal ADR group,and the differences were statistically significant(P<0.05).Elevated BMI was a protective factor for the occurrence of gastrointestinal adverse reactions in patients with T2DM(OR=0.520,P=0.003),and female gender,no less than 60 years of age,increased dosage of GLP-1RA,history of gastrointes-tinal disorders,duration of T2DM of greater than or equal to 2 years,and the number of co-administered other medications of greater than 1 were risk factors for the occurrence of gastrointestinal adverse reactions in patients with T2DM(OR=2.858,1.055,2.008,4.909,2.179,1.933,all P<0.05).Conclusion The T2DM patients who are treated with GLP-1RA have a risk of gastrointestinal adverse effects,elevated BMI was a protective factor for gastrointestinal adverse effects,female gender,age 60 years,increased dose of GLP-1RA,history of gastrointestinal disease,long disease course of T2DM,and combination of other drugs are the risk factors.For patients meeting the above conditions,medication should be more cautious and intervention strategies should be adjusted accord-ing to their symptoms.