早期胰岛素强化治疗降低2型糖尿病患者大血管并发症的疗效观察

Efficacy of early insulin intensive treatment on reducing macrovascular complication in patients with type 2 diabetes mellitus

目的观察早期门冬胰岛素联合甘精胰岛素强化治疗2型糖尿病对减少大血管并发症的疗效。方法 42例初次诊断的2型糖尿病患者分为胰岛素联合强化治疗组(22例)和常规药物治疗组(20例),强化治疗组患者接受门冬胰岛素联合甘精胰岛素治疗;常规口服药物组患者接受瑞格列奈或加用其他降糖药治疗。检测两组患者治疗开始、12个月和18个月时空腹血糖、低密度脂蛋白LDL;用B超检查患者颈总动脉内膜中层厚度的变化。结果治疗开始时,两组患者空腹血糖、低密度脂蛋白和颈总动脉内膜中层厚度均差异无统计学意义;治疗12个月和18个月后,胰岛素联合强化组和常规药物治疗组患者空腹血糖差异无统计学意义,均达正常指标,控制良好;治疗18个月后胰岛素联合强化组患者LDL和IMT显著低于常规药物治疗组。结论早期胰岛素强化治疗可延缓T2DM大血管并发症的发生。

Objective To observe the efficacy of early insulin aspart and glargine treatment on reducing macrovascular complication in patients with type 2 diabetes mellitus. Methods 42 cases of initial diagnostic T2DM patients were divided into intensive insulin therapeutic group （22 cases） and routine drug therapeutic group（20 cases）. The patients in intensive insulin therapeutic group received insulin aspart and glargine insulin therapy, and the patients in routine drug therapeutic group received repaglinide or other hypoglycemic agents. The changes of fasting blood glucose, low density lipoprotein in plasma, and the carotid artery intima-media thickness with Utrasonic B were detected at the beginning, twelve and eighteen months later of treatment in both treatment groups. Results In the beginning of the treatment, there was no statistically significant difference on plasma FBG, biochemical indicators of LDL, and IMT between two groups. After 12 and 18 months treatment, the plasma FBG level in both treatment group return to normal standard, and there was no significant difference between two groups. Whereas the plasma LDL and IMT were significantly lower in intensive insulin therapeutic group than those of routine drug therapeutic group. Conclusion Early intensive insulin combine treatment can reduce the occurrence of macrovascular complications in type 2 diabetes mellitus.