初诊2型糖尿病患者24小时动态血糖与胰岛β细胞功能及胰岛素抵抗的关系

Relationship of 24-hour continuous blood glucose with function of islet beta cell and insulin resistance in firstly diagnosed type 2 diabetic patients

目的:探讨初诊2型糖尿病患者空腹血糖、24h动态血糖、糖化血红蛋白及胰岛β细胞功能、特点及其关系。方法:将初诊2型糖尿病患者35例、正常人群30例分成初诊组、正常组,查空腹血糖、24h动态血糖及胰岛素,采用稳态模式评估法的胰岛素抵抗指数(homeostasismodelassessment,HOMA-IR)及胰岛β细胞基础分泌指数(homeostasismodelassessment,HOMA-βcell);采用糖负荷30min净增胰岛素/30min净增葡萄糖(ΔI30/ΔG30)评价早期胰岛素分泌功能。结果:初诊组患者空腹血糖(11.4±2.2)mmol/L、24h平均血糖(15.5±3.6)mmol/L、餐后1h血糖(17.3±3.1)mmol/L、餐后2h血糖(16.6±3.2)mmol/L、餐后3h血糖(13.6±3.5)mmol/L、糖化血红蛋白(9.7±1.1)%均比正常组高(t=3.524～3.535,P<0.01)。初诊组患者HOMA-βcell(92.4±22.4),ΔI30/ΔG30(23.9±6.3);均比正常组低(t=2.826,2.835,P<0.05)。初诊组患者HOMA-IR(8.4±1.3);均比正常组高(t=2.837,P<0.05)。当平均血糖值超过11.1mmol/L,患者HOMA-βcell及ΔI30/ΔG30明显下降;但患者HOMA-IR却变化不大。结论:初诊2型糖尿病患者空腹血糖、24h平均血糖、餐后2h血糖高;全程持续高血糖是初诊2型糖尿病患者的主要特点,2型糖尿病胰岛β细胞功能受损的在初诊患者表现更为明显。

AIM:To investigate fasting blood glucose(FBG),24-hour continuous blood glucose,glycosylated hemoglobin A(HbA1c) and function of islet beta(β)cell in firstly diagnosed type 2 diabetic patients,also the characteristics and relationship. METHODS:FBG,24-hour continuous blood glucose,and insulin were measure in 35 firstly diagnosed type 2 diabetic patients(first diagnosis group) and 30 healthy subjects(normal control group).Homeostasis model assessment insulin resistance(HOMA-IR) and Homeostasis model assessment βcell secretion index(HOMA-βcell) were adopted,early islets insulin secretion index was assessed by adopting the ratio of the increase in insulin to the increase in glucose 30 min after oral glucose loading(ΔI30/ΔG30). RESULTS:The levels of FBG,24-hour continuous blood glucose,1,2 and 3-hour postprandial glucose and HbA1c were all higher in the patients of the first diagnosis group[(11.4±2.2) mmol/L,(15.5±3.6) mmol/L,(17.3±3.1) mmol/L,(16.6±3.2) mmol/L,(13.6±3.5) mmol/L,(9.7±1.1)%] than in the normal control group(t=3.524 to 3.535,P< 0.01).HOMA-βcell and ΔI30/ΔG30 in the first diagnosis group[(92.4±22.4),(23.9±6.3)] were lower than those in the normal control group (t=2.826, 2.835,P< 0.05).HOMA-IR was higher in the first diagnosis group(8.4±1.3) was higher than in the normal control group(t=2.837,P< 0.05).When the average level of blood glucose exceeded 11.1 mmol/L,HOMA-βcell and ΔI30/ΔG30 were significantly decreased,but HOMA-IR had no obvious change. CONCLUSION:The levels of FBG,24-hour average blood glucose and 2-hour postprandial glucose are higher in the firstly diagnosed type 2 diabetic patients,and the lasting hyperglycemia is their main characteristics.The impairment of β-cell function is more significantly in the type 2 diabetic patients.