胰岛素联合文迪雅治疗对新发2型糖尿病患者β细胞功能的影响

Clinical research of the application of the insulin treatmentin treating the new diagnosed type 2 diabetes mellitus

目的探讨新诊断2型糖尿病(DM)患者应用胰岛素联合文迪雅治疗的效果。方法采用开放随机平行对照方法将82例新诊断2型DM患者分为两组。单用组42例,单用胰岛素治疗;联用组26例,胰岛素加罗格列酮联合治疗。治疗前及治疗12周末做口服糖耐量(OGTT)试验及胰岛素释放试验,检测0、30、60、120、180min血糖(BG)、C肽(CP)水平等,根据结果计算△CP30/△BG30等。评估胰岛素治疗对新诊断2型DM患者胰岛β细胞功能的价值。结果两组均使FBG、2hPBG、HbA1c水平明显下降,且联用组显著优于单用组(P<0.01)。两组均可改善△CP30/△BG30;联用组△CP30/△BG30明显增加,显著优于单用组(P<0.05)。结论对于新诊断2型DM出现胰岛β细胞功能衰减的患者,早期应用胰岛素可明显降低血糖,减轻胰岛β细胞负荷,使胰岛β细胞功能得到部分改善,如果胰岛素与胰岛素增敏剂联合使用效果最佳。

Objective The study is to investigate the effectiveness of the application of the insulin treatment in treating new diagnosed type 2 diabetes mellitus. Methods 83 patients with new diagnosed type 2 diabetes mellitus were randomly divided into three groups. Group 1 uses the insulin treatment set 27 cases;Croup 2 uses the insulin adds msiglitazone maleate treawaent set 26 cases;The control group 29 cases only use gipizide.To measure OGTT experiment 0, 30, 60, 120, 180 minute blood sugar（BG）, serum insulin, the C peptide（CP） level etc. Before and after the treatrnent. Calculate the CP（ △CP30/△BG30 ） secreted in early days, and evaluate the valuation of insulin B cell function of new diagnosed type 2 diabetes mellitus in insulin treawaent. Results All the groups could obviously decrease the level of empty stcrnaeh BG, after meal BG and HbAIe, and the study group is evidently set to show better effectiveness than the control group（ P 〈0.01） .The serum △CP30/△BG30 level could be obviously improved in the study group;The insulin adds the rosiglitazone treatment show an increment of △CP30/△BG., showing the better resulting than the group of using the insulin set and control group（ P 〈 0.05, P 〈 0.01 ）. Conclusion To applicate the insulin earlier in treating the patients of the new diagnosed type 2 diabetes mellitus, whose insulin island B cell function reduced, could obviously decrease the BG, lighten the burden of insulin island, improve the function of insulin island B cell partly, especially those which use insulin adds rosiglitazone maleate treatment could get the best effectiveness.