胰岛素泵治疗对不同BMI初发2型糖尿病患者胰岛功能的影响

Effects of insulin pump treatment on islet function in newly diagnosed type 2 diabetes mellitus patients with the different body mass index

目的探讨胰岛素泵治疗对不同BM I初发2型糖尿病患者胰岛功能的影响。方法选择初发2型糖尿病患者42例,以BM I 25 kg/m2为界限,分为消瘦组16例和肥胖组26例,均采用胰岛素泵强化治疗2周。治疗前后检测空腹血糖、胰岛素,口服75 g葡萄糖负荷后0.5、2 h血糖和胰岛素水平,并应用HOMA公式和ΔI30Δ/G30评价胰岛素抵抗和胰岛β细胞功能改善情况,分析BM I与HOMA-B和ΔI30Δ/G30的关系。结果治疗前肥胖组与消瘦组胰岛功能无统计学差异(P均>0.05);治疗后两组胰岛功能均有明显改善(P均<0.05),肥胖组较消瘦组改善更明显(P均<0.05),BM I与HOMA-B和ΔI30Δ/G30呈正相关(r分别为0.688、0.746,P均<0.05)。结论胰岛素泵强化治疗能显著改善初发2型糖尿病患者的胰岛功能,其中肥胖患者胰岛功能改善更明显。

Objective To evaluate the influence of the continuous subcutaneous insulin infusion（CSII） treatment on islet function in newly diagnosed type 2 diabetes mellitus patients.Methods Forty-two newly diagnosed type 2 diabetes mellitus patients were divided two groups such as the fat group（n=26） and the macilent group（n=16）,according to the body mass index limit 25 kg/m2.All patients were treated by CSII for two weeks.Fasting plasma glucose and insulin,0.5 hours postprandial glucose（0.5 h PG） and insulin and 2 h PG and insulin after oral 75 g glucose were measured before and after CSII treatment.The improvement of beta cell function and the insulin resistance were compared by Homa formula and ΔI30/ΔG30.Results There were no obviously differences in the beta cell function of two groups before CSII treatment（all P0.05）.After CSII treatment,the beta cell functions of two groups were improved significantly（all P0.05）,the fat group improved more significantly compared to the macilent group（all P0.05）.BMI was positively related with HOMA-B and ΔI30/ΔG30（r=0.688,0.746,all P0.05）.Conclusion The islet functions of both groups are improved after the treatment of CSII,the fal patients improve more significantly.