吡咯列酮与胰岛素联用对2型糖尿病患者β细胞早期胰岛素分泌的影响

Impact of Pioglitazone Combined with Insulin on Early Phase Insulin Secretion of β-Cells Function in Type 2 Diabetic Patients

目的探讨吡咯列酮与胰岛素联用对2型糖尿病患者β细胞早期胰岛素分泌的影响。方法将40例2型糖尿病患者随机分为单纯胰岛素组和吡咯列酮与胰岛素联用组,各20例。在饮食及运动治疗的基础上,分别给予两种治疗方法治疗12周,比较两组治疗前后空腹血糖(FBG)、餐后2 h血糖(2 hPBG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、C肽糖负荷后0～30 min曲线下面积(AUCcp0～30)、胰岛素β细胞功能指数(HOMA-β)和胰岛素抵抗指数(HOMA-IR)的变化。结果治疗12周后,两组患者的FBG、2 hPBG、HbA1c、HOMA-IR均较治疗前显著降低,FINS、AUCcp0～30、HOMA-β较治疗前均显著升高,差异有统计学意义(P<0.05),且吡咯列酮与胰岛素联用组各指标改善效果优于单纯胰岛素组。结论吡咯列酮联合胰岛素治疗2型糖尿病能改善胰岛β细胞早相胰岛素分泌功能,有利于血糖的长期控制。

Objective To study the protective effect of Pioglitazone combined with insulin on period insulin secretion of β-cell function in patients with type 2 diabetes mellitu.Methods Forty patients with type 2 diabetes mellitu were randomly divided into two groups,Pioglitazone combined with insulin group and insulin group.On the basic dietary and exercise therapies,the course of treatment was 12weeks.fasting blood glucose（FBG）,2-hour postprandial blood glucose（2 hPBG）,fasting serum insulin（FINS）,glycosylated hemoglobin（HbA1c）,area under curve of C peptide 0~30 min after glucose load（AUCcp0~30）,HOMA index of β-cell function（HOMA-β） and HOMA insulin resistance index（HOMA-IR） were compared between the two groups.Results After 12-week treatment,FBG,2 hPBG,HbA1c and HOMA-IR were significantly increased in both group;while FINS,AUCcp0~30,and HOMA-β were significantly decreased（P0.05）.The improvement was more significant in Pioglitazone combined with insulin group than in insulin group.Conclusion The therapy of Pioglitazone combined with insulin can effectively improve the early phase insulin secretion of β-cell,being helpful to long term control of blood glucose.