短期应用胰岛素泵输注人胰岛素类似物对初诊2型糖尿病患者胰岛β细胞功能影响的观察

Effects of short-term continuous subcutaneous insulin analog infusion on beta-cell function in newly diagnosed type 2 diabetic patients

目的观察短期应用胰岛素泵输注人胰岛素类似物对伴明显高血糖的初诊2型糖尿病患者的降糖效果和胰岛β细胞功能的影响。方法采用自身前、后对照,对19例空腹血糖>11.1mmol/L的初诊2型糖尿病患者进行2周的CSⅡ强化治疗,分析比较治疗前、后FBG、2hBG、HbA1c、胰岛β细胞功能Homaβ及胰岛素抵抗指数Homa IR的变化。结果治疗2周后,19例患者的空腹和餐后2h血糖分别于治疗后(4.3±2.6)d、(3.9±2.3)d达到良好控制;FBG和2hBG水平均较治疗前显著下降(P<0.001);HbA1c、Homa IR较治疗前下降(P<0.05),Homaβ较治疗前显著增高(P<0.005)。结论对伴明显高血糖的初诊2型糖尿病患者,短期应用胰岛素泵持续皮下输注人胰岛素类似物具有快速控制血糖、减轻胰岛素抵抗,从而明显改善胰岛细胞功能的作用。

Objective To observe the effect of short-term continuous subcutaneous insulin analog infusion （CSⅡ） treatment on plasma glucose and beta-cell function in newly diagnosed type 2 diabetic patients with severe hyperglycemia. Methods Before-after study in the same patient was applied. Nineteen newly diagnosed type 2 diabetic patients with first plasma glucose（FBG）〉11. 1mmol/L were treated by CSⅡ for 2 weeks. The results of FBG,2hBG, HbA1c, Homa-β and Homa-IR were compared before and after CSⅡ. Results The excellent control of FBG and 2hBG of 19 patients were achieved stably in （4.3 ± 2.6）d and （3.9 ± 2.3） d by CSⅡ. After 2 weeks of CSⅡ intensive treatment, FBG, 2hBG, HbA1c and Homa-IR were decreased （P〈0. 001 or P〈 0.05）. Homa-β was significantly increased compared with before treatment（P〈0. 005）. Conclusion The excellent glycemic control, improvement of beta-cell function and insulin sensitivity can be induced by short-term CSⅡ intensive therapy in newly diagnosed type 2 diabetic patients with severe hyperglycemia.