强化治疗对初诊2型糖尿病β细胞功能影响的研究

Study on the influence of intensive treatment on B cell function of newly-diagnosed type 2 diabetes mellitus

目的:探讨二种不同疗法对2型糖尿病β细胞功能的影响。方法:将100例初诊2型糖尿病患者分为二组:强化治疗组和口服药组。强化组用胰岛素泵连续皮下输注,使血糖完全达标。强化治疗15 d后停止皮下连续输注。口服药组口服降糖药物,使血糖达标。患者均在治疗前测体重,空腹血糖,空腹胰岛素水平,糖化血红蛋白,馒头餐试验检测0、0.5 h、2h胰岛素水平,并计算空腹胰岛素／空腹血糖。3个月后复查上述指标。结果:强化治疗组空腹胰岛素／空腹血糖值,0.5 h胰岛素水平有明显升高(P<0.05),口服药组空腹胰岛素／空腹血糖值,0.5 h胰岛素水平无明显改变,而2 h胰岛素水平有明显升高(P<0.05)。结论:皮下连续输注治疗可使血糖,糖化血红蛋白控制的更好,空腹胰岛素／空腹血糖0.5h胰岛素水平明显升高。皮下连续输注强化治疗使β细胞功能恢复,而口服药组胰岛素释放延迟更明显,加重β细胞负担,不利于β细胞功能的恢复。

Objective To study the influence of 2 kinds of treatments on B cell function of T2DM. Methods One hundred newly-diagnosed type 2 diabetic patients were divided into intensive treatment group and orally taking medicine group. Intensive treatment group received insulin pump subsutaneous injection continuously till the blood glucose reaching standard. After 15 days treatment the subsutareous injection was stopped orally taking medicine group received medicine orally till the blood glucose reaching standard. Before treatments, the body temperature FPG, FINS, HbA1C of all the patients were measured,the test of food was given in 0,0. 5 h,2 h to detect insulin level,and calculate the FINS/FPG. After 3 months,re-exam the obove indices. Results In intensive treatment group the FINS/FPG,0.5 h insulin level rised obviously and did not change obviously in orally takinginedicine group. But 2 h insulin level rised obviously (P<0.05). Conclusion Continuous subcutaneous injection can control the blood glucose. HbA1C better,FINS/FPG and 0. 5 h insulin level rise obviously. The intensive treatment of subcutaneous injection can restore B cell function. In taking medicine group, insulin releases slowly. It makes the burden of B cell heavier. It's not good to the restore of B cell function.