餐后2小时C肽与空腹C肽比值(C_2/C_0)作为预测新诊断的2型糖尿病胰岛素强化治疗指标的观察

The C_2/C_0 ratio(2 h postprandial over fasting C-peptide ratio) may be a predictive index for glucose control after insulin intensive therapy in newly diagnosed type 2 diabetes

目的探讨100g馒头餐2hC-P与FC-P比值(C2/C0)在胰岛素强化治疗中的临床意义。方法新诊断的T2DM患者87例,分为Ⅰ组(C2/C0≥3,n=43)和Ⅱ组(C2/C0<3,n=44),经2～3周的胰岛素强化治疗,随访3个月,比较两组间的降糖方案和血糖控制情况。结果Ⅰ组比Ⅱ组有更多的患者可采用单独生活方式干预控制血糖良好(20/43 vs 5/44,P<0.05);Ⅱ组比Ⅰ组有更多的患者需胰岛素控制血糖(21/44 vs 9/43,P<0.05);需用口服降糖药者两组间病例数上差异无统计学意义(14/43 vs18/44,P>0.05),Ⅰ组患者比Ⅱ组患者需要的口服降糖药少。结论新诊断的T2DM患者的C2/C0比值,可作为胰岛素强化治疗的预测指标,C2/C0≥3的患者胰岛素强化治疗的获益更大。

Objective To investigate whether the ratio of the 2 h postprandial to fasting C-peptide （C2/C0） can be a predictive index for glucose control after intensive insulin therapy in newly diagnosed type 2 diabetes. Methods Eighty-seven newly diagnosed type 2 diabetic inpatients were divided into two groups： group I （C2/C0 ratio ≥ 3, n = 43 ） and group 11 （C2/C0 ratio （ 3, n = 44）, then treated with continuous subcutaneous insulin infusion for 2 - 3 weeks, followed up after 3 months. The levels of glycemia control were compared between two groups. Results Compared to group II , there were more patients in group I getting good glycemia control by life style intervention alone（20/43 vs 5/44, P〈 0.05）. Group II showed that more patients （21/44 vs 9/43, P〈0.05） needed insulin treatment, as compared to group I . Conclusions The ratio of C2/C0 can be used as a predictive index for glycemia control after short-term intensive insulin therapy in newly diagnosed type 2 diabetic patients. The patients with C2/C0 ≥3 can get more benefits from short-term intensive insulin therapy than those with C2/C0 〈3.