首诊2型糖尿病患者胰岛素分泌及抵抗情况调查及干预效果分析

A Survey of Insulin Secretion and Insulin Resistance among the Patients with Initial Diagnosis on Type 2 Diabetes and Analysis on the Effect of Treatment

目的调查北京地区肥胖及非肥胖首诊2型糖尿病患者胰岛素分泌功能、胰岛素抵抗状况,并探讨降糖药物对其影响。方法对2010年1月至2011年12月中国人民解放军海军总医院首诊的2型糖尿病患者128例检测胰岛素敏感性和胰岛素抵抗相关指标,进行肥胖组与非肥胖组干预治疗前后比较。结果干预治疗前,非肥胖组胰岛素敏感性指数(ISI)明显高于肥胖组,而稳态模型法胰岛素抵抗指数(HOMA-IR)低于肥胖组,肥胖组早期胰岛素分泌指数(ΔINS30/ΔPG30)明显高于非肥胖组;干预治疗后,两组的ISI、稳态模型法β细胞功能指数(HOMA-β)及ΔINS30/ΔPG30升高,而HOMA-IR降低。结论首诊2型糖尿病患者中,肥胖组患者的胰岛素敏感性比非肥胖组差,胰岛素分泌能力优于非肥胖组;服用降糖药、纠正高血糖可使糖尿病患者的胰岛素分泌功能及胰岛素敏感性均得到改善。

Objective To investigate the status of insulin secretion and insulin resistance among the obese and the non-obese patients with initial diagnosis of type 2 diabetes and analyze the effect of treatment. Methods 128 patients of initial diagnosis of type 2 diabetes in Marine General Hospital of PLA during Jan. 2010 to Dec. 2011 were conducted some tests to detect insulin sensitivity and insulin resistance related indi- cators. Results Before intervention treatment, insulin sensitivity index （ISI） in non-obese patients was signif- icantly higher than that of the obese group, and the homeostasis model insulin resistance index（HOMA-IR） was lower than the obese group＇s. But the early insulin secretion index（AINS30/APG30） of the obese group was significantly higher than non-obese patients＇. After intervention treatment, the two groups＇ ISI, HOMA-~, and AINS30/APG30 increased and HOMA-IR decreased. Conclusion For patients with initial diagnosis of type ：2 diabetes, the insulin sensitivity of obese group is worse than that of the non-obese group ,insulin secre- tory capacity is better than that of non-obese group. Taking hypoglycemic drugs to correct high blood sugar can improve diabetic patients insulin secretion and insulin sensitivity.