血糖达标治疗与常规治疗初诊2型糖尿病C肽分泌功能的比较

The Comparison of the C-peptide Secrete Function between Intensive Glycemic Control and Routine Therapy in Patients with Newly Diagnosed Type 2 Diabetes Mellitus

目的探讨血糖达标治疗与常规治疗对初诊2型糖尿病患者C肽分泌功能的影响。方法初诊2型糖尿病患者111例选用非胰岛素刺激性药物治疗后,根据HbA1c达标情况分组:≤6.5%者53例,>6.5%者58例。对OGTT血糖、C肽值及C肽功能指数进行组间比较。结果与常规组比较,达标组患者:(1)OGTT的5个时点血糖值均显著降低(P<0.001);(2)0min、60min和120min的C肽值显著升高(P<0.05);(3)C肽功能指数HOMA-β、△C30/△G30、AUCC-P和DI均显著升高(P<0.05),而HOMA-CR的组间差异无统计学意义(P>0.05)。结论早期达标治疗的初诊2型糖尿病患者较常规治疗者更能显著改善其高血糖状态、C肽的基础分泌、早时相分泌和晚时相分泌功能以及葡萄糖处理能力。

Objective To study the difference of intensive glycemic therapy and routine therapy on ameliorate the C-peptide secrete function in newly diagnosed type 2 diabetes mellitus. Methods Newly-diagnosed type 2 diabetes mellitus patients were randomized into study. After 3 -12 months treatment with insulin or metformin or acarbose or pioglitazone, all cases were divided into 2 groups by HbA1C ： group 1 ≤6.5% （ n = 53） and group 2 〉 6.5% （ n = 58 ）. Then those groups were making a comparison in OGTT blood glucose, C-peptide and its function index. Results In the intensive glycemic therapy group ： （ 1 ） OGTT blood glucose were significantly decreased （P 〈 0. 001 ）;（2）0 min,60 rain and 120 min time of OGTT blood C-peptide were significantly increased （P 〈 0.05）;（3）HOMA-β, △C30/△G30, AUCC-P and DI were significantly increased （P 〈 0.05 ）. However, HOMA-CR were not markedly different between two groups （P 〉 0.05）. Conclusion Early intensive glycemic therapy not only could related the disease course but increased the secrete function of C-peptide with the newly： diagnosed type 2 diabetes mellitus patients than routine glycemic therapy.