短程强化血糖控制对初诊2型糖尿病患者胰岛β细胞功能的影响

Effects of short term intensive blood glucose control on islet β cell function in patients newly diagnosed type 2 diabetic

目的探讨单纯口服降糖药（OHA）、单纯胰岛素强化治疗（Ins）对短病程、未用过降糖药的2型糖尿病（T2DM）患者减轻胰岛素抵抗、改善胰岛功能的效应差异。方法60例病程≤1年、未用过降糖药的T2DM患者随机分为2组，即OHA组、Ins组。每组有效病例30人，进行强化降糖治疗，以末梢空腹血糖≤6．5mmol／L和餐后2h血糖≤8．0mmol／L为血糖控制目标，使血糖在5—10d达标，并维持达标4周。比较2组治疗前后的静脉葡萄糖耐量试验（IVGTT）胰岛素第一时相分泌、胰岛素抵抗指数（Homa A）和胰岛素分泌指数（Homa B）的变化。结果2组治疗后IVGTT曲线下面积和HomaB均明显升高，HomaA明显下降。2组间治疗前后变化的差异不显著。结论2种强化降糖治疗方案均可以使短病程、未用过降糖药的T2DM患者胰岛素抵抗以及胰岛β细胞功能得到同样程度的改善。

Objective To investigate the different effect of oral hypoglycemic agents （OHA） and simple insulin intensification therapy on insulin resistance and β cell function of patients with short disease duration and naive type 2 diabetic. Methods Sixty newly diagnosed and naive type 2 diabetic patients （the diabetic duration≤ 1 year） were randomly divided into two groups, treated with OHA and insulin respectively. Each group included 30 cases and was put on intensive blood glucose control. The targets for blood glucose control were fasting blood glucose less than 6.0mmol/L, and two hours postprandial blood glucose less than 8.0mmoL/L, which were achieved in 5-10 days, and had been lasted for 4 weeks.Before and after intensive therapy, intraw,,nous glucose tolerance test （IVGTT） which was performed to calculate AUCIns0-10min, Homa A and Homa B between two groups were compared. Results After intensive treatment, AUCIns0-10min and Homa B of the two groups increased, but Homa A decreased. There were no significant differences between two groups.Conclusion The same excellent improvement of insulin sensitivity and β cell function could be obtained by two ways of intensive glucose treatment in short disease duration and naive type 2 diabetic patients.