短期胰岛素强化治疗新诊断2型糖尿病患者84例疗效观察

Effect observation of short-term intensive insulin therapy in 84 patients newly diagnosed with type 2 diabetes

目的:观察短期胰岛素强化治疗新诊断2型糖尿病患者的疗效。方法:对84例新诊断2型糖尿病患者采用3餐前30 min及睡前皮下注射胰岛素强化治疗,2～4周使血糖得到有效控制,然后分别行饮食、运动和药物治疗(降糖药物或降糖药物联合胰岛素),随防6个月,比较治疗前、后患者空腹血糖(FBG)、餐后2 h血糖(2 h PG)、空腹胰岛素(FINS)、餐后2h胰岛素(2 h INS)、糖化血红蛋白(HbA1c)、β细胞指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)、三酰甘油(TG)、总胆固醇(TC)、体重指数(BMI)指标的变化。结果:治疗后FBG、2 h PG、HOMA-IR及HbA1c水平较治疗前显著下降(P<0.01),2 h INS、HOMA-β水平较治疗前显著上升(P<0.01),FINS、BMI、TG、TC水平与治疗前比较,差异无统计学意义治疗(P>0.05)。结论:短期胰岛素强化治疗能改善新诊断2型糖尿病患者胰岛素分泌功能和胰岛素的敏感性,有效控制血糖,值得临床推广。

Objective： To observe the effect of short-term intensive insulin therapy in newly diagnosed type 2 diabetes patients.Methods： 84 patients who were newly diagnosed with type 2 diabetes were given subcutaneous insulin therapy in 30 min before three meals and before sleep.Blood glucose was effectively controlled in 2 to 4 weeks,then the patients were given diet,exercise and medications therapy（hypoglycemic drugs or descending sugar,insulin drug combination）.All patients were followed up 6 months,and the FBG,2 h PG,FINS,2 h INS,HbA1c,HOMA-β,HOMA-IR,TG,TC,BMI were compared before treatment and after treatment.Results： Six months after treatment,the FBG,2 h PG,HOMA-IR and HbA1c decreased significantly（P〈0.01）,2 h INS,HOMA-β increased significantly（P〈0.01）,FINS,BMI,TG,TC had no significant change（P〈0.05）.Conclusion： Short-term intensive insulin therapy can improve insulin secretion and insulin sensitivity in patients newly diagnosed type 2 diabetes,control blood sugar effectively,and it is worthy of promotion.