短期胰岛素泵治疗伴腹型肥胖的初诊2型糖尿病的效果及对胰岛β细胞功能影响的观察

The effects of short-term insulin pump treatment on beta-cell function in newly diagnosed type 2 diabetic patients with abdominal obesity

目的:观察短期胰岛素泵治疗对伴腹型肥胖和明显高血糖的初诊2型糖尿病患者的降糖效果及对胰岛β细胞功能的影响。方法:对同时伴有腹型肥胖和明显高血糖的40例初诊2型糖尿病患者进行为期2周的胰岛素泵治疗,比较治疗前后FPG、2hPG、GHbA1C、空腹血浆胰岛素及OGTT时胰岛素曲线下面积(AUC)和胰岛素敏感性指数(ISI)的变化情况。结果:治疗后显示出快速稳定的降血糖效果,且未见明显低血糖现象;胰岛β细胞功能获得显著改善,AUC和ISI均较治疗前明显升高,空腹血浆胰岛素无明显变化。结论:对伴腹型肥胖和明显高血糖的初诊2型糖尿病患者,采用短期胰岛素泵治疗具有快速稳定控制血糖和显著改善胰岛β细胞功能的作用。

Objective： To evaluate the effect of short-term insulin pump treatment on plasma glucose and beta-cell function in newly diagnosed type 2 diabetic patients with abdominal obesity and severe hyperglycemia. Methods： Forty newly diagnosed type 2 diabetic patients with abdominal obesity（male waist circumference（WC）≥85 cm,female waist circumference（WC）≥80 cm）and severe hyperglycemia（fasting plasma glucose（FPG） ≥11.1 mmol/L）were treated by 2 weeks insulin pump treatment. An oral glucose tolerance test （OGTT）was performed before and after insulin pump treatment. FPG, 2 hours postprandial glucose（2 hPG）, glycosylated hemoglobin Alc （GHbAlc）and insulin during OGTT were measured. The results of FPG,2hPG,GHbAlc, fasting plasma insulin, the mean area under the curve （AUC）of insulin and insulin sensitivity index（ISI）were compared. Results：The excellent control of FPG and 2hPG was achieved stably by 2 weeks insulin pump treatment. After 2 weeks insulin pump treatment,beta-cell function was dramatically improved：the mean AUC of insulin and ISI were significantly increased, fasting plasma insulin was not increased. Conclusions： The excellent glycemic control and improvement of beta-cell function can be induced by short-term insulin pump treatment in newly diagnosed type 2 diabetic patients with abdominal obesity and severe hyperglycemia.