双相门冬胰岛素强化治疗对初诊2型糖尿病患者胰岛β细胞功能的影响

Effect of biphasic insulin aspart 30 on pancreatic beta-cell function in newly diagnosed type 2 diabetes mellitus

目的观察预混双相门冬胰岛素30(BIAsp30)对初诊2型糖尿病患者血糖控制及其对胰岛β细胞功能的影响。方法对122例初诊2型糖尿病患者,分为BIAsp30治疗组和口服降糖药(OHD)治疗组,治疗6个月,检测两组中层得治疗前后空腹及75克葡萄糖负荷后血糖、胰岛素、C肽、糖化血红蛋白(HbA1c)、胰岛β细胞功能指数(△I/△G)、胰岛素抵抗指数(HomaIR)等指标,比较两组患者血糖控制及胰岛β细胞功能恢复情况。结果BIAsp30和OHD具有降低血糖、改善胰岛β细胞功能的作用,治疗前后比较,差异有非常显著性(P<0.01);两组之间比较,BI-Asp30组在改善患者胰岛β细胞功能、降低胰岛素抵抗方面,明显优于OHD组(P<0.01),且血糖达标所需时间短于OHD组,差异有非常显著性(P<0.01)。结论对新诊断的2型糖尿病患者,早期给予每日两次注射BIAsp30强化治疗能更好的控制血糖,改善和恢复胰岛β细胞功能、降低胰岛素抵抗。

Objective To study the impact of biphasic insulin aspart 30 （BIAsp30） on plasma glucose control and beta-cell function in newly diagnosed type 2 diabetes mellitus. Methods One hundred and twenty two newly diagnosed type 2 diabetes mellitus were divided into two groups. They were treated respectively with BIAsp30 and oral hypoglycemic drugs （OHD）for six monthes. 75-g oral glucose tolerance test （OGIT） 0 mintue, 120 mintues glucose, insulin, C-peptide and glycosylated hemoglobin A1c were tested before and after treatment in two groups;Insulin secretion index （ ΔI/ΔG）, Insulin resistance index （ Homa IR） were measured before and after treatment in two groups. Results BIAsp30 and OHD treatments can equally achieve the execellent control of glucose and improvement of beta-cell function （ P 〈 0.01 ） ;compared between two groups, beta-cell function was improved and insulin resistence index was decreased dramatically in BIAsp30 group than in OHD group（ P 〈 0.01 ）, and BIAsp30 group could receive faster control on blood glucose than OHD group （P 〈 0.01 ）. Conclusion The execellent glycemic control and improvement of beta-cell function in newly diagnosed .type 2 diabetic patients can be induced by twice daily biphasic insulin aspart 30 infusion.