个体化干预2型糖尿病一级亲属的临床研究

The Study of Individuation Treatment in the First-degree Relatives of Type 2 Diabetics

目的:探讨糖耐量正常的2型糖尿病患者一级亲属第一时相胰岛素分泌,实施早期干预、保护β细胞的意义。方法:通过75g葡萄糖耐量试验,56例糖耐量正常一级亲属进入研究,配偶为对照(54例),生活方式和二甲双胍干预。测定受试者血脂、血糖、第一时相胰岛素分泌等。结果:①2型糖尿病一级亲属存在第一时相胰岛素分泌受损,胰岛素抵抗及脂代谢异常。②与对照组相比,一级亲属组空腹血糖、空腹胰岛素升高,差异有显著性(P<0.05)。③个体化干预后,一级亲属组血脂、空腹胰岛素下降,明显改善急性胰岛素反应,生活方式干预组优于药物干预。结论:2型糖尿病一级亲属具有糖尿病高发风险,实施生活方式干预或药物干预具有可行性。

Objective： To evaluate the first - phase of insulin secretion in normal glucose tolerant first - degree relatives of patients with type 2 diabetes mellitus and early intervene to protect islet beta - cell. Method ： 56 cases of normal glucose tolerant first - degree relatives of patients with type 2 diabetics were determined by 75g oral glucose tolerance test （OGTT）. Their spouses （ 54 cases） were selected as control group. The first - degree relatives were random divided into two groups ; life style intervene group, and Metformin group. The level of blood glucose, TG,, TC, first - phase of insulin secretion were determined. Result： ①Insulin secretion dysfunction , insulin resist and TG, TC abnormity existed in normal glucose tolerant first - degree relatives of patients with type 2 diabetics. ②fasting blood glucose and fasting insulin of first - degree relatives were evidently higher than control group （ P 〈 0.05 ）. ③ blood glucose and fasting insulin of first -degree relatives were decreased after individuation treatment. Conclusion： The first -degree relatives of diabetics had higher risk to be diabetes. The diabetes prevalence in first - degree relatives can be reduced by given life style intervene.