短期胰岛素强化治疗初诊2型糖尿病的临床效果观察

Effects of Short-term Intensive Insulin Treatment on Newly Diagnosed Type2 Diabetic Patients

目的:探讨短期胰岛素强化治疗对2型糖尿病(T2DM)患者的临床治疗效果。方法:T2DM患者121例,随机分为短期胰岛素强化治疗组(61例)和口服降糖药物组(60例),治疗4周后分析比较两组空腹血糖达标时间、空腹血糖、餐后2 h血糖(PBS2)、GHbA1c、空腹C肽水平及胰岛β细胞功能Homa-β及胰岛素敏感性指标Homa-IR的变化。结果:4周的胰岛素强化治疗显示了快速稳定的降血糖效果,其中胰岛素强化治疗组空腹血糖达标时间(8.5±2.5)d较口服药物组的达标时间(20.5±3.5)d短,空腹血糖、PBS2和GHbA1c水平均较对照组显著下降(均为P<0.05)。而且胰岛素强化治疗组的胰岛β细胞功能在治疗后也获得显著改善,表现为C肽水平和Homa-β较口服药物组明显提高(均为P<0.05),而Homa-IR较对照组明显降低(P<0.05)。结论:短期胰岛素强化治疗可有效快速控制初诊T2DM患者血糖,改善其胰岛β细胞功能。

Objective： To explore the effect of short-term intensive insulin treatment on newly diagnosed type 2 diabetic patients. Methods： One hundred and twenty-one newly diagnosed type 2 diabetic patients were random- ly divided into short-term intensive insulin treatment and oral hypoglycemic agents. After 4 weeks of treatment, FBS, glycosylated hemoglobin Alc （GHbAlc）, 2 h postprandial blood sugar （PBS2）, Homa-[3 and Homa-IR were measured and compared between two groups. Results： After 4 weeks of short-term intensive insulin treat- ment, the excellent control of FBS were achieved in （8.5 -＋ 2.5） d, and with increased Homa-[3. FBS, PBS2, GHbAlc and Homa-IR in the intensive insuin reatment group were significantly decreased comared with group of o- ral hypoglycemic agents treatment （P 〈0.05）. Conclusions： The excellent glycemia control and improvement of [3-cell function can be induced by short-term intensive insulin treatment in newly diagnosed type 2 diabetic patients with severe hyperglycemia.