胰岛素泵短期强化治疗初诊2型糖尿病的临床观察

The clinical observation of short-term intensive treatment of new diagnosed type 2 diabetes by insulin pump

目的观察胰岛素泵短期治疗明显高血糖的初诊2型糖尿病患者的降糖效果及胰岛β细胞功能和胰岛素敏感性的改变。方法将32例空腹血糖≥10mmol/L初诊的2型糖尿病患者进行为期两周的胰岛素泵强化治疗,分析比较其治疗前后口服葡萄糖耐量试验及C肽曲线下面积、胰岛素分泌指数、胰岛素抵抗指数。结果短期两周的胰岛素泵治疗显示出快速稳定的降糖效果,治疗后口服糖耐量试验出现明显增加的C肽曲线下面积,胰岛素分泌指数明显增加,胰岛素抵抗指数显著改善(P<0.05)。结论对伴明显高血糖的初诊2型糖尿病患者,胰岛素泵短期强化治疗可以快速稳定地控制血糖,显著改善胰岛β细胞功能和胰岛素的敏感性,值得临床推广。

Objective In order to observe the efficacies of short - term intensive treatment and the changes of islet B - cell function and insulin sensitivity with insulin bump in new - diagnosed type 2 diabetic patients with obvious high blood glucose. Methods Thirty - two cases of new - diagnosed type 2 diabetic patients with FBG over 10. 0 mmol/L were all treated with short - term intensive insulin bump therapy for 2 weeks, then compared oral glucose tolerance test, the area under curve of C peptide, insulin - release indexes and insulin - resistance indexes before and after the treatment. Results Short - term insulin bump therapy for two weeks showed quick and stable efficiency in lowering blood glucose; the obviously increased area under curve of C peptide appeared in oral glucose tolerance test after the treatment ; insulin - release indexes were also prominently added ; insulin - resistance indexes were improved obviously as well （ P 〈 0. 05 ）. Conclusions To the new - diagnosed type 2 diabetic patients with obvious high blood glucose, short - term intensive therapy by insulin bump can control blood glucose quickly and stably, and prominently improve islet B - cell function and insulin sensitivity. Therefore, this therapy is worth clinical application widely.