早期强化与常规治疗对初诊2型糖尿病患者β细胞功能与胰岛素抵抗的影响比较

Comparison of effects of early intensive therapy and conventional therapy on β- cell function and insulin resistance in patients with preliminary diagnostic type 2 diabetes

目的探讨强化治疗与常规治疗对初诊T2DM患者胰岛β细胞功能与胰岛素抵抗(IR)的影响比较。方法将2012年4月—2013年4月在本院内分泌科诊治的56例初诊2型糖尿病患者随机分为强化组和常规治疗组。强化组应用胰岛素泵,常规治疗组应用降糖药物治疗,连续治疗4个疗程。比较2组患者治疗前后FBG、HbAlc、TC、TG、HDL-C、LDL-C、HOMA-β、HOMA-IR的水平。结果治疗后2组患者血清TC、TG、HDL-C、LDL-C较同组治疗前有明显改善(P<0.05或P<0.01),FBG、HbAlc、HOMA-β、HOMA-IR较治疗前有显著差异(P<0.05或P<0.01)。结论早期胰岛素泵强化治疗可以有效控制血糖,降低血脂,改善胰岛素抵抗,恢复胰岛β细胞功能,缓解2型糖尿病的临床症状,减缓2型糖尿病的病程。

Objective To compare the effects of early intensive therapy and conventional therapy onβ- cell function and insulin resistance in patients with preliminary diagnostic type 2 dia- betes. Methods 56 patients with preliminary diagnostic type 2 diabetes from April 2012 to April 2013 were randomly divided into intensive therapy group and conventional therapy group. The in- tensive therapy group was treated with insulin pump, while the conventional therapy group was treated with metformin andglucobay. Levels of FBG, t-IbAlc, TC, TG, HDL- C, LDL- C, HOMA-β and HOMA - IR were compared before and after treatment in both groups. Results The levels of TC,TG,t-IDL- C and LDL- C were significantly better than those before treatment in both groups（P〈0.05 or P〈0.01）, and the levels of FBG, HbAlc, HOMA- βand HOMA- IR were significantly better than those before treatment（P 〈 0.05 or P 〈 0.01）. Conclusion Applica- tion of early intensive insulin pump therapy can effectively control the levels of blood sugar and fat, improve insulin resistance, restore pancreati@cells function, alleviate the clinical symptoms of type -2 diabetes and shorten course of disease.