胰岛素泵强化治疗初诊2型糖尿病

Effects of Intensive Insulin Therapy with Insulin Pump in Newly Diagnosed Type 2 Diabetic Patients

目的探讨初诊的2型糖尿病患者接受胰岛素泵短期强化治疗后及中期的临床效果。方法使用胰岛素泵对31例初诊2型糖尿病患者进行为期3周的持续胰岛素皮下输注(CSII)强化治疗,比较治疗前后及6个月后血糖、胰岛素、C肽、果糖胺(FA)、糖化血红蛋白(GHbA1c)、胰岛β细胞功能(HOMA-β)和胰岛素抵抗指数(HOMA-IR)等。结果治疗后的空腹及餐后血糖达到良好控制;FA显著降低(P<0.05),1hC肽较治疗前显著升高(P<0.01)。HOMA-IR和HOMA-β明显改善(P<0.05,P<0.05)。结论胰岛素泵CSII强化治疗能在短时间内达到理想血糖控制,有利于胰岛β细胞功能的恢复,部分患者能够获得较长时间的血糖控制。

Objective To observe the effects of type 2 diabetic patients. Methods 31 newly diagnosed intensive insulin therapy in newly diagnosed type 2 diabetic patients were treated by continuous subcutaneous insulin infusion （CSII） with insulin pump. Fasting plasma glucose （FPG）, 2 hours postprandial glucose （ 2hPG）, fructosamine （ FA）, glycosylated hemoglobin A 1 c （ GHbAIC ） , insulin and C- peptide were measured. HOMA - β and HOMA - IR were calculated. Results After 3 weeks intensive treatment, the excellent control of FPG and 2hPG in all patients were achieved, the level of FA decreased （ P 〈 0.05 ）, The level of 1 h C - peptide was significantly higher than that before treatment（ P 〈0.01 ）. HOMA -IR were decreased and HOMA-β were increased significantly （ P 〈 0.05, P 〈 0.02 ）. Conclusion The excellent glycemic control and improvement of β cellfunction can be induced by short -term CSII intensive therapy in newly diagnosed type 2 diabetic patients. Some of patients can acquire longer improvement.