皮下注射甘精胰岛素对初次诊断的2型糖尿病患者糖脂代谢、胰岛素测定的影响

The effect of therapy with glargine on glucolipid metabolism and insulin detection in newly diagnosed type 2 diabetic patients

目的:探讨甘精胰岛素对门诊初诊的2型糖尿病(type 2 diabetes mellitus,T2DM)患者糖脂代谢、胰岛B细胞功能、胰岛素测定的影响。方法:32例初诊T2DM患者,给予甘精胰岛素每晚定时皮下注射1次,剂量为0.2～1.0 U/(kg.d),治疗3个月后观察体重、血糖、血脂、血压、胰岛素抵抗指数、胰岛素分泌指数的变化。结果:3个月后患者血糖、血脂、血压、糖化血红蛋白(HbA1c)均显著降低,差异有统计学意义(P<0.05);治疗前后体重没有明显变化,甘精胰岛素使用后,胰岛素分泌曲线较前上升,且口服葡萄糖耐量试验(OGTT)后呈典型的胰岛素分泌曲线,即治疗后胰岛素分泌指数显著增加,胰岛素抵抗指数显著改善,胰岛素早期相分泌前移,差异均有统计学意义(P<0.05或P<0.01),且治疗后胰岛素分泌曲线及高峰与C-肽一致。结论:甘精胰岛素短期内可有效改善患者的血糖、血脂、血压水平及胰岛细胞分泌功能,且不影响糖耐量试验下胰岛素分泌的检测,提示血浆检测胰岛素与甘精胰岛素具有不同的免疫原性。

Objective：To evaluate the therapy effects of glargine on glucolipid metabolism and B-cell function,insulin detection in newly diagnosed type 2 diabetes mellitus（T2DM） patients.Methods：Thirty-two cases of newly diagonosed T2DM,were treated with subcutaneous injection of glargine at fixed time everyday.Fasting serum glucose,blood lipid,blood pressure,the HOMA-IR were detected and compared after three months treatment.Results：After three months treatment,blood lipid,blood pressure,blood glucose,glycohemoglobin A1c（HbA1c） were significantly lower,the bodyweight had no signifancanct difference compare with the un-treatment group;the level of the HOMA-B were significantly higher after treatment;the HOMA-IR were significantly lower（P 〈 0.01）.Conclusion： Glargine can effectively improve,control serum glucose,blood lipid,blood pressure,and the glaginetreatment did not influence the detection of insulin.