早期胰岛素强化治疗对初诊2型糖尿病患者胰岛β细胞功能的影响

The Effect of Early Intensive Insulin Treatment on the Function of Pancreatic Islet β-cells in the Patients with Newly-diagnosed Type 2 Diabetes Mellitus

目的:探讨早期胰岛素强化治疗对伴明显高血糖的初诊2型糖尿病患者胰岛β细胞功能的影响。方法:将80例伴明显高血糖的初诊2型糖尿病患者给予胰岛素强化治疗3月,观察患者治疗前后血糖、胰岛素水平、糖化血红蛋白、胰岛β细胞功能指数、胰岛素抵抗指数变化,以及停药后血糖达标持续时间。结果:80例患者接受胰岛素强化治疗后,空腹及餐后血糖、糖化血红蛋白、胰岛素抵抗指数均较治疗前明显下降,胰岛素分泌水平、胰岛β细胞功能指数较治疗前明显升高。随访6个月,其中36例仅通过饮食控制及体育锻炼即可获得理想的血糖控制。结论:初诊2型糖尿病患者通过早期胰岛素强化治疗后可有效控制血糖,显著改善胰岛β细胞功能,减轻胰岛素抵抗。

Objective： To assess the effect of early intensive insulin therapy on the function of pancreatic islet β-cells in the patients with newly diagnosed type 2 diabetic. Methods： Intensive insulin treatment of 3 months was given to 80 cases of newly-diagnosed type 2 diabetes mellitus with high blood glucose,with their blood glucose level,insulin level,HbA1c level, the islet β-cell function index（ HOMA-B） and insulin resistance index（ HOMA-IR） observed and determined before and after the treatment. Results： Compared with those before the treatment,80 patients＇ fasting and postprandial plasma glucose level,HbA1c level and HOMA-IR remarkably lowered and their insulin secretion and HOMA-B significantly increased after 3-month intensive insulin treatment. The result of 6-month follow-up showed that 36 patients could maintain ideal blood glucose level only by diet control and exercise. Conclusion： Early intensive insulin therapy can effectively control and maintain the blood glucose level,remarkably improve the function of pancreatic β-cells and notably reduce the insulin resistance in the patients with newly diagnosed type 2 diabetic.