门冬胰岛素30联合阿卡波糖治疗对初诊2型糖尿病患者胰岛β细胞的保护作用

The effect of insulin aspart 30 combined with acarbose on beta cell function improvement with newly diagnosed type 2 diabetes

目的:探讨门冬胰岛素30联合阿卡波糖治疗初诊2型糖尿病患者,患者糖代谢和胰岛β细胞功能的改善情况。方法:选取30例糖化血红蛋白(HbA1c)>8.5%的初诊2型糖尿病患者,在严格饮食控制的基础上予以12周的门冬胰岛素30联合阿卡波糖治疗方案。患者在治疗前后,连续3 d监测指尖血糖,计算平均空腹血糖(FPG)及餐后2 h血糖(PPG),并检测HbA1c;同时进行75 g口服葡萄糖耐量试验,计算胰岛素抵抗指数(HOMA-IR)、胰岛细胞分泌功能指数(HOMA-β),早相胰岛素分泌指数(ΔI30/ΔG30),第二时相胰岛素分泌指数(AUCI)。结果:治疗后,患者血糖控制情况FPG、PPG、HbA1c较治疗前明显降低(P<0.05),HOMA-IR明显改善(P<0.05),HOMA-β和ΔI30/ΔG30均明显提高(P<0.05),AUCI治疗前后无明显变化(P>0.05)。结论:门冬胰岛素30联合阿卡波糖治疗初诊2型糖尿病患者,不仅有效改善糖代谢,而且能保护胰岛β细胞功能,改善早相胰岛素的分泌。

Objective：To study the joint use of insulin aspart 30 combined acarbose treatment in patients with newly diagnosed type 2 diabetes,the glucose metabolism in patients with pancreatic β-cell function and improve the situation.Methods：Selected 30 cases of glycosylated hemoglobin（HbA1c）8.5% of newly diagnosed type 2 diabetes,based on strict diet to be 12 weeks on insulin aspart 30 combined acarbose treatment.Patients before and treatment,fingertip blood glucose monitoring for 3 consecutive days,calculate the average fasting plasma glucose（FPG） and 2 h postprandial glucose（PPG）,and detection of HbA1c,simultaneously 75 g oral glucose tolerance test,insulin resistance index（HOMA-IR）,islet-cell function index（HOMA-β）,early-phase insulin secretion index（△I30/△G30）,the second-phase insulin secretion index（AUCI）.Results：After treatment,blood glucose control in patients with FPG,PPG,HbA1c was significantly lower than that before treatment（P0.05）,HOMA-β and insulin secretion are △I30/△G30 significantly improved compared with before treatment（P0.05）,AUCI before and after treatment no significantly change（P0.05）.Conclusion：Newly diagnosed type 2 diabetes using insulin aspart 30 combined acarbose combination therapy,not only improve glucose metabolism,but also to protect the β-cell function,improved early-phase insulin secretion.