诺和笔加诺和锐短期胰岛素强化治疗对初诊2型糖尿病患者血糖长期良好控制的临床研究

NovoPen+insulin aspart short-term intensive insulintherapythe clinical research in recently diagnosed type 2 diabetic patients with long-term optimal glucose control

目的探讨短期通过用诺和笔三餐前皮下注射胰岛素类似物———诺和锐,睡前22∶00皮下注射诺和灵N强化治疗对改善2型糖尿病患者胰岛β细胞功能和血糖控制的影响。方法对空腹血糖>11.1mmol/L的50例初诊2型糖尿病患者进行为期2周诺和笔+诺和锐强化治疗,分析比较治疗前后空腹及口服葡萄糖耐量试验(OGTT)2 h血糖、空腹及OGTT2h血浆胰岛素、糖化血红蛋白(HbA1c)。由稳态模型(Homa)计算的Homaβ指数。结果治疗2周后,有40例患者仅采用饮食控制,平均随访6个月时,糖化血红蛋白为(5.52±0.54)%,空腹血糖为(5.94±0.66)mmol/L,OGTT2h血糖为(8.02±1.27)mmol/L,空腹胰岛素为(21.83±10.12)μIu/ml,OGTT2h血胰岛素为(54.14±17.70)μIu/ml,Homaβ指数明显升高(P<0.001)。结论用诺和笔加诺和锐短期强化治疗可以快速稳定控制血糖并显著改善胰岛β细胞功能。

Objective To investigate the effect of short-term intensive insulin therapy via subcutaneous injection of insulin analog-aspart before three meals and Novolin N at 10pm before sleep with a NovoPen. On the improvement of pancreas β-cell function and glucose control in type 2 diabetic patients. Methods Recently diagnosed 50 type 2 diabetes with fasting glycemia（ 〉 11.1 mmol/L） has received an intensive therapy with aspart and Novolin N for two weeks.Analyze and compare fasting and OGTT2h glucose concentration, plasma insulin, and hemoglobin A1c（HbA1c） before and after the therapy,Homa 19 index calculated with a Homa model. Results 40 patients have a decreased HbA1 c （ 5.52 ± 0.54 ） % , fasting glucose （5.94 ± 0.66） mmol/L, OGTT2h glucose （8.02 ±1.27 ） mmol/ L and fasting insulin （21.83 ± 10.12 ） μlu/ml, OGTT2h blood insulin （ 54.14 ±17.70） μlu/ml, a significantly increase Homa β index（P〈 0. 001 ）. Conclusion Short-term intensive therapy with NovoPen and aspart can rapidly and stably control glucose and significantly improve β-cell function.