基础及早期胰岛素分泌对2型糖尿病患者血糖水平的贡献

Contribution of basal and early phase insulin secretion to plasma glucose level in patients with type 2 diabetes

目的 探讨 2型糖尿病人群基础及早期胰岛素分泌对血糖水平的贡献。方法 2型糖尿病患者 81例 ,测定标准餐试验 0、3 0、60、12 0min血浆葡萄糖及真胰岛素水平。计算胰岛素敏感性指数 (ISI)和早期胰岛素分泌 (ΔI3 0 /ΔG3 0 ) ,以评估机体胰岛素敏感性 ,以多因素回归方法评估早期及基础胰岛素分泌对2型糖尿病人群血糖变化的贡献。结果 多因素回归分析显示 ,ISI和ΔI3 0 /ΔG3 0 对血糖变化的贡献几乎相等。在标准餐试验各时点胰岛素值中 ,空腹及 60min血浆真胰岛素水平对血糖水平的变化起主要作用 ;空腹胰岛素对血糖曲线下面积的作用强于ΔI3 0 /ΔG3 0 的作用。

Objective To investigate the effects of basal and early phase insulin secretion on plasma glucose level in type 2 diabetes. Methods Plasma glucose and true insulin levels were measured at 0, 30, 60, 120 min during standard meal test in 81 patients with type 2 diabetes. Insulin sensitivity index (ISI) and insulin secretion index (ΔI 30 /ΔG 30 ) were calculated for evaluating the insulin sensitivity. Contributions of basal and early insulin secretion to plasma glucose level were evaluated by multivariate regression analysis with SAS software. Results ISI and ΔI 30 /ΔG 30 showed nearly equal effects on plasma glucose levels by multivariate regression analysis. Among insulin levels of different time points during standard meal test, basal and postprandial 60 min insulin levels played important roles in changes of plasma glucose levels. The effect of fasting insulin on the area under plasma glucose curve was stronger than that of ΔI 30 /ΔG 30 . Conclusion Both basal and early insulin secretions greatly contribute to glycemic control.