早期胰岛素泵强化治疗对初诊肥胖2型糖尿病患者血内脏脂肪素的影响

Effect of Early Insulin Pump Intensive Therapy on Visfatin of Newly Diagnosed Obese Type 2 Diabetes

目的探讨早期胰岛素泵持续皮下胰岛素输注治疗对初诊肥胖与非肥胖2型糖尿病患者血内脏脂肪素影响的差异性。方法初诊2型糖尿病患者60例,根据体重指数是否大于25kg/m2随机分为肥胖组(Ob)和非肥胖组(Non-Ob),每组30例,均给予胰岛素泵强化治疗2周。比较两组治疗前后BMI、FPG、2hPG、FINS、C-P、GA、HOMA-IR、WC、WRH及VF等变化情况。结果 Ob组和Non-Ob组治疗前后FPG、2hPG、GA、VF、HOMA-IR均较治疗前明显下降,FINS、C-P均较治疗前明显升高,差异均具有统计学意义(P<0.05);Ob组VF、FPG、2hPG、GA、FINS、HOMA-IR及C-P治疗前后变化量明显高于Non-Ob组(P<0.05),而两组BMI、WC及WRH治疗前后比较及两组变化量比较,差异均无统计学意义(P>0.05)。VF与BMI、WC、WHR、HOMA-IR、FPG呈正相关。结论早期胰岛素泵强化治疗在升高初诊肥胖2型糖尿病患者FINS及C-P,降低FPG、2hPG、GA、VF及HOMA-IR等方面均优于非肥胖患者。早期胰岛素泵强化治疗不仅具有平稳降糖和改善β细胞功能、部分恢复餐后胰岛素早时相分泌作用,而且改善胰岛素抵抗、延缓糖尿病并发症发生发展。

Objective To evaluate the difference in the effect of early insulin pump intensive therapy on visfatin between newly diagnosed obese type 2 diabetes and non-obese type 2 diabetes. Methods Sixty cases of newly diagnosed type 2 diabetes were randomly divided into two groups： obese type 2 diabetes group and non-obese type 2 diabetes group, with 30 cases in each, and both groups received insulin pump intensive therapy for 2 weeks. The changes in BMI, FPG, 2hPG, FINS, C-P, GA, HOMA-IR, WC, WRH and VF were compared between the two groups before and after therapy. Results FPG, 2hPG, GA, VF and HOMA-IR were significantly decreased in both groups after treatment than before treatment, and FINS and C-P were significantly higher after treatment than before treatment, with a significant difference （P〈0.05）. The changes in VF, FPG, 2hPG, GA, HOMA-IR, FINS and C-P of the obese group before and after treatment were significantly higher than those of the non-obese group（P〈0.05）, and there were no significant differences in BMI, WC and WRH between the two groups before and after treatment（P〉0.05）.VF was positively correlated with BMI, WC, WHR, HOMA-IR and FPG. Conclusion The effect of early insulin pump intensive therapy is superior to non-obese type 2 diabetes in the increase in FINS and C-P and the decrease in FPG, 2hPG, GA, VF and HOMA-IR in newly diagnosed obese type 2 diabetes. Early insulin pump intensive therapy not only stabilizes the blood glucose and improves the β-cell function, with the partial restoration of postprandial early phase insulin secretion, but also improves insulin resistance and delays the development of diabetic complications.