【摘要】 目的：观察司美格鲁肽联合二甲双胍在肥胖老年2型糖尿病（T2DM）患者中的应用效果。方法：选取2024年5月—2025年6月东莞市莞城人民医院内分泌科收治的肥胖老年T2DM患者60例，根据随机数字表法分为两组，各30例。对照组应用二甲双胍治疗，联合组应用二甲双胍联合司美格鲁肽治疗。比较两组治疗效果。结果：治疗前，两组糖化血红蛋白、空腹血糖、餐后2 h血糖水平比较，无统计学差异（P>0.05）；治疗后，联合组糖化血红蛋白、空腹血糖、餐后2 h血糖水平低于对照组（P<0.001）。治疗前，两组体质量指数及胰岛功能指标比较，无统计学差异（P>0.05）；治疗后，联合组体质量指数及胰岛素抵抗指数低于对照组（P<0.001），胰岛β细胞功能指数高于对照组（P<0.001）。两组不良反应总发生率比较，无统计学差异（P>0.05）。结论：司美格鲁肽联合二甲双胍在肥胖老年T2DM患者中的应用效果显著，可降低血糖、减轻体质量指数、改善胰岛功能，且安全性良好。更多还原

【Abstract】 Objective: To observe the application effect of semaglutide combined with metformin in obese elderly patients with type 2 diabetes(T2 DM). Methods: Sixty elderly patients with type 2 diabetes mellitus(T2 DM) and obesity who were admitted to the department of endocrinology of Dongguan Guancheng People’s Hospital from May 2024 to June 2025 were selected. They were divided into two groups according to the random number table method, with thirty cases in each group. The control group was treated with metformin, while the combined group was treated with metformin combined with semaglutide. The therapeutic effects of the two groups were compared. Results: Before treatment, there was no statistically significant difference in the levels of P glycosylated hemoglobin, fasting blood glucose, and 2-hour post-meal blood glucose between the two groups(>0.05). After treatment, the levels of glycosylated hemoglobin, fasting blood glucose, and 2-hour post-meal blood glucose in the combined group were lower than those in the control group(P<0.001). Before treatment, there was no statistically significant difference in body mass index and pancreatic function indicators between the two groups(P>0.05). After treatment, the body mass index and insulin resistance index of the combined group were lower than those of the control group(P<0.001), and the pancreatic β-cell function index was higher than that of the control group(P<0.001). The comparison of the total incidence rates of adverse reactions P between the two groups showed no statistical difference(>0.05). Conclusion: The application of semaglutide combined with metformin in obese elderly patients with type 2 diabetes mellitus shows significant effects. It can lower blood glucose, reduce body mass index, improve pancreatic function, and has good safety.更多还原