短期胰岛素强化治疗对新诊断2型糖尿病患者相关指标的影响

Effects of transient intensive insulin treatment on the related indices of newly diagnosed T2DM patients

目的探讨短期胰岛素强化治疗对新诊断T2DM患者相关指标的影响。方法采用多次皮下注射(MSII)和胰岛素泵持续皮下输注(CSII)方案对64例新诊断T2DM患者进行短期强化治疗,比较治疗前后FPG、2hPG、TC、TG、LDL-C、HDL-C、FFA、C-RP、精氨酸刺激试验、胰岛素分泌指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)的变化。结果治疗达标后两组FPG、2hPG、TC、TG、LDL-C、FFA、C-RP、HOMA-IR均下降(P<0.05),HOMA-β、快速胰岛素分泌值(Ins2+4+6)增高(P<0.05),两组间差异无统计学意义(P>0.05);Pearson相关分析显示,HOMA-β、Ins2+4+6的升高与FPG、FFA下降呈正相关(P<0.05),多元逐步回归分析显示,BMI是影响HOMA-β、Ins2+4+6的独立相关因素(P=0.000)。结论短期胰岛素强化治疗可明显改善新诊断T2DM患者的胰岛β细胞功能,减轻IR,胰岛β细胞功能的改善与糖脂代谢的改善及体重密切相关。

Objective To study the effect of transient intensive insulin treatment on the related indices of newly diagnosed T2DM patients.Methods Sixty-four newly diagnosed T2DM patients were divided into two groups and treated by transient intensive insulin treatment in the way of multiple subcutaneous insulin infusion（MSII） and continuous subcutaneous insulin infusion（CSII）.The FPG,2 hPG,TC,TG,LDL-C,HDL-C,FFA,C-RP,arginine stimulation test（Ins 0,2,4,6 minute）,HOMA-β,and HOMA-IR were determined before and after treatment for comparison.Results After treatment in both groups the levels of FPG,2 hPG,TC,TG,LDL-C,FFA,C-RP,and HOMA-IR were decreased significantly（P0.05）,and the levels of HOMA-β and Ins2＋4＋6 were increased significantly（P0.05）.There was no significant difference between the two groups（P0.05）.Pearson correlation analysis showed that the increase of HOMA-β and Ins2＋4＋6 was positively correlated with the decrease of FPG and FFA（P0.05）.The multiple regression analysis showed that BMI was an independent related factor affecting HOMA-β and Ins2＋4＋6（P=0.000）.Conclusion The transient intensive insulin treatment can evidently improve β-cell functions and relieve insulin resistance in newly diagnosed T2DM patients.The improvement of islet β-cell function is related to the improvement of glucose metabolism,lipid metabolism,and bodyweight.