短期速效胰岛素联合长效胰岛素强化治疗对初诊2型糖尿病患者胰岛功能及氧化应激的影响

The Effect of Short-term Acting Insulin plus Long-term Intensive Insulin On Islet Function and Oxidative Stress of Newly Diagnosed Type 2 Diabetic Patients

目的:探讨短期速效胰岛素联合长效胰岛素强化治疗方案对初诊2型糖尿病患者胰岛功能及氧化应激的影响。方法:选择30例初诊2型糖尿病患者,在一般治疗的基础上,应用短期速效胰岛素联合长效胰岛素强化治疗方案进行治疗,检测并比较患者治疗前后一般血清指标包括空腹血糖(FBG)、餐后2小时血糖(2h PPG)、糖化血红蛋白(HbA1c)、血清C肽(FCP),胰岛细胞功能指标包括胰岛素曲线下面积(AUG)、β细胞功能稳态模型评估(HOMA-B)、I30/G30、胰岛素抵抗指数(HOMA-IR)、胰岛素及C肽水平,以及氧化应激指标包括丙二醛(MDA)及超氧化物岐化酶(SOD)。结果:(1)与治疗前相比,患者治疗后FPG、2h PPG、HbA1c、AUG、HomaB、HomaIR及I30/G30水平均显著改善,差异均有统计学意义(P均<0.05);患者口服糖耐量试验0h、1h及2h胰岛素水平及C肽水平均显著回升,差异有统计学差异(P<0.05)。(2)治疗后,患者MDA水平显著降低,SOD水平显著升高,其差异有统计学意义(P<0.05)。结论:短期速效胰岛素联合长效胰岛素强化治疗方案可以明显改善初诊2型糖尿病患者胰岛功能,降低患者体内的氧化应激水平。

Objective： To investigate the effect of islet function and oxidative stress of short-term acting insulin and long-term intensive insulin in the treatment of newly diagnosed type 2 diabetic patients.Methods： 30 cases of newly diagnosed patients with type 2 diabetes were chosen.On the basis of general treatment,we used short-term insulin ＋ long-term insulin therapy program.Serum markers,including fasting blood glucose（FBG）,2-hour postprandial blood glucose（2h PPG）,glycated hemoglobin（HbA1c）,serum C-peptide（FCP）,islet cell function parameters before and after treatment were detected and compared.Insulin area under the curve（AUG）,insulin resistance index（HOMA-IR）,insulin and C-peptide levels,beta cell function in the homeostasis model assessment（HOMA-B）,I30/G30,as well as oxidative stress indicators including malondialdehyde（MDA） and superoxidedismutase（SOD） were compared.Results： 1.Compared with before treatment,the levels of FPG,2 h average PPG,HbA1c,AUG,HomaB HomaIR and I30/G30 after treatment were significantly improved,which was statistically significant（P0.05）.After treatment,the oral glucose tolerance test 0h,1 h and 2 h insulin levels and C-peptide levels increased significantly compared with before treatment,with significant differences（P0.05）.2.After treatment,the MDA levels significantly decreased,the SOD levels significantly increased,which were statistically significant（P0.05）.Conclusion： In the treatment of newly diagnosed type 2 diabetic patients,short-term acting insulin ＋ long-term intensive insulin treatment programs can significantly improve islet function,as well as reduce oxidative stress.