胰岛素泵快速控制新诊断2型糖尿病患者高血糖状态对胰岛β细胞功能的影响

The influence of rapidly controlling hyperglycemia with insulin pump on β-cell function of newly diagnosed type 2 diabetic patients

目的了解胰岛素泵对胰岛β细胞功能的影响。方法对新诊断51例2型糖尿病(T2DM)患者FBG≥15 mmol/L者,分别行胰岛素强化治疗和口服降糖药治疗,观察其血清C-肽浓度的变化。结果强化组治疗4天血糖达标后血清C-肽曲线下面积无明显变化,继续皮下注射胰岛素治疗半年后明显升高(P<0.001)。口服降糖药组亦有改善(P<0.01)。但半年后两组结果显示:应用胰岛素组优于口服降糖药组(P<0.001)。结论胰岛素泵数日快速控制严重高血糖不能消除高血糖毒性对胰岛β细胞功能的抑制,对新诊断的FBG≥14 mmol/L的T2DM患者胰岛素治疗应该持续数月以期改善胰岛功能。

Objective To investigate the influence of insulin pump on type 2 diabetes mellitus. Methods 51 patients were randomized into two groups： 31 cases controlled with insulin pump, 20 treated with oral antidiabetic drugs. Serum level of C-peptide concentration was observed. Results There was a markedly increase in C peptide level in both insulin treating group （P〈0. 001） and oral drug group （P〈0.01）, Half an year later, the insulin group was improved in β-cell function better than oral drug group. Conclusions Several days controlling of severe hyperglycemia with insulin pump could not eliminate the β-cell inhibition of glucose toxicity. Newly diagnosed severe type 2 diabe tes （FPG≥14 mmol/L） could be treated with insulin for several months.