诺和锐30强化治疗对初诊2型糖尿病患者的疗效及胰岛β细胞功能的影响

Effect of insulin aspart 30 intensive treatment on plasma glucose and pancreatic function in patients with newly diagnosed type 2 diabetic.

目的探讨门冬胰岛素30(诺和锐30)短期强化治疗对伴有明显高血糖的初诊2型糖尿病(T2DM)患者的疗效及胰岛功能的影响。方法对40例初诊2型糖尿病患者在饮食和运动治疗基础上给予诺和锐30强化治疗12周,分析比较治疗前后空腹血糖(FPG)、空腹胰岛素(FINS)、空腹C肽(F-C)、糖化血红蛋白(HbAlc)、总胆固醇(TC)、甘油三脂(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、体质指数(BMI)、餐后2小时血糖(2hPG)、餐后2小时胰岛素(2h-INS)、餐后2小时C肽(2h-C)、胰岛素分泌指数(HOMA-IS)、胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(ISI)和FINS/FPG比值的变化。结果40例患者血糖达标时间为(8.3±1.5)d,治疗后FPG、2hPG、HbAlc、TC、TG、LDL-C、HOMA-IR较治疗前均有显著下降(P<0.05),HDL、FINS、2h-INS、F-C、2h-C、HOMA-IS、ISI、FINS/FPG较治疗前明显升高(P<0.01),BMI稍有增高,但差别无统计学意义,治疗过程中无严重不良反应。结论对伴有明显高血糖的初诊T2DM患者,用诺和锐30强化降糖,可保护胰岛β细胞功能,间接改善血脂紊乱。

Objective To investigate the effect of insulin aspart 30 intensive treatment on plasma glucose and pancreatic function in patients with newly diagnosed type 2 diabets. Methods Forty patients with newly diagnosed type 2 diabetes were treated with insulin aspart 30 for 12 weeks. An oral glucose tolerance test was performed before and after treatment. The level of fasting plasma glucose （FPG） , fasting serum insulin （ FINS）, fasting C - peptide（ F - C）, glycosylated hemoglobin Alc （ HbA1c）, total cholesterol（ TC）, low - density lipoprotein - cholesterol （ LDL - C）, triglyceride （TG）, high -density lipoprotein -cholesterol （HDL -C）, 2 hours postprandial plasma glucose （2hPG）, 2 hours postpran- dial C - peptide （ 2h - C ）, 2 hours postprandial insulin （ 2h - INS）, body mass index （ BMI ）, insulin resistance index （ HOMA - IR）, insulin secretion index （HOMA -IS）, insulin sensitivity index （ISI） and ratio of fasting insulin to fasting glucose （FINS/FPG） were compared before and after insulin aspart 30 treatment. Results After treatment, FPG, 2hPG, HbA1c, TC, TG, LDL - c and HOMA - IR were significantly decreased （ P 〈 0.05 ） ; while HDL - C, FINS, 2h - INS, F - C, 2h - C, HOMA - IS, ISI and FINS/FPG were significantly increased （ P 〈 0. 01 ）. Conclusion Insulin aspart 30 intensive treatment can satisfactorily control plasma glucose level, improve 15 - cell function and blood lipid disturbance in patients with newly diagnosed type 2 diabetes.