吡格列酮对初诊2型糖尿病患者胰岛素强化治疗长期缓解的影响

Effect of pioglitazone on long-term remission in newly diagnosed type 2 diabetic patients with intensive insulin treatment

目的观察吡格列酮对初诊2型糖尿病患者胰岛素强化治疗长期缓解的影响。方法选择67名初诊2型糖尿病患者随机分成2组:胰岛素强化治疗组(Ins组)和胰岛素强化+吡格列酮治疗组(Ins+Pio组)。治疗4个月后:(1)记录胰岛素强化所用时间。(2)检测血糖、血脂、糖化血红蛋白、胰岛素、C肽水平。(3)ELASA法测定血清内脂素(Visfatin)的变化。结果 (1)Ins+Pio组血糖达标所需胰岛素强化治疗时间较Ins组短(P<0.05)。(2)随访3月后Ins+Pio组缓解率高(P<0.05),且Ins+Pio组缓解者中空腹血糖、糖化血红蛋白、HOMA-IR均低于Ins组缓解者,HOMA-β高于Ins组缓解者(P<0.05);Ins+Pio组缓解者Visfatin治疗前后变化大(P<0.05)。结论吡格列酮可以缩短初诊2型糖尿病患者胰岛素强化治疗时间,增加长期缓解机会。这种作用与Visfatin浓度变化有关。

Aim To observe the effect of pioglitazone on long-term remission in newly diagnosed type 2 diabetic patients with intensive insulin treatment.Methods 67 patients with newly diagnose type 2 diabetes were randomly divided into two groups：intensive insulin therapy group（Ins group） and insulin＋ pioglitazone group（Ins ＋ Pio group）.4 months after treatment were detected and time of intensive insulin was recorded,blood glucose,blood lipids,glycated hemoglobin,insulin,C peptide levels.Serum concentrations before and after the therapy was measured by ELASA method.Results Insulin pump treatment time blood glucose for standardizing was shorter in Ins＋Pio group than that in Ins group（P0.05）.3 months later remission rate（61.7%） in Ins＋Pio group was higher than that in Ins group.And fasting plasma glucose,glycosylated hemoglobin,HOMA-IR in Ins ＋ Pio group remission were lower than those in Ins group remission,while HOMA-β was higher（P0.05）.3 months later serum Visfatin changed greatly in Ins＋Pio group before and after treatment（P0.05）.Concultion Pioglitazone can reduce the insulin pump treatment time in newly diagnosed type 2 diabetic patients and increase opportunities for long-term remission.And the effect is related to changes in Visfatin concentration.