2型糖尿病微血管病变患者的胰岛素分泌功能分析

Study of insulin secretion function in type 2 diabetes with microangiopathy

目的 探讨 2型糖尿病微血管病变患者的胰岛分泌功能情况及相关因素。方法 应用馒头餐—胰岛素释放试验对 115例 2型糖尿病患者 ,其中有微血管并发症 5 6例 ,无微血管并发症 5 9例 ,以及正常对照组 2 5例进行血糖、胰岛素测定 ,计算血糖、胰岛素曲线面积、胰岛素敏感性指数、胰岛素分泌指数 ,并进行了比较。结果 糖尿病两组各时相血糖值及血糖面积均非常显著高于正常对照组 ;糖尿病有微血管病变组各时相血糖值及血糖面积高于无微血管病变组 (P均 <0 .0 0 1)。糖尿病有微血管病变组各时相胰岛素值及胰岛素面积均显著低于无微血管病变组 (P均 <0 .0 1)。糖尿病有微血管病变组胰岛素分泌指数显著低于无微血管病变组 (P <0 .0 0 1)。多元 L ogistic逐步回归分析显示 ,微血管病变与糖尿病病程呈显著正相关 ,与胰岛素分泌指数呈显著负相关。结论 2型糖尿病微血管病变患者存在严重的持续性高血糖。糖尿病病程的延长 ,严重的胰岛分泌功能障碍为

Objective To investigate the islet dysfunction in type 2 diabetes with microangiopathy and correlation factors. Method 115 type 2 diabetes (including 56 with microangiopathy and 59 without microangiopathy) and 25 healthy objects were observed. The test of steamed bread meal was used. The area of blood sugar and insulin, insulin sensitivity index (IAI) and insulin secretion index (IS) were calculated in all objects.Results The results showed that the values of blood sugar in each time phase and the areas of blood sugar in both type 2 diabetes groups were significantly higher than those of healthy objects. The values of blood sugar in each time phase and areas of blood sugar in type 2 diabetes with microangiopathy were significantly higher than those without microangiopathy (P<0 001). The values of insulin in each time phase and areas of insulin in type 2 diabetes with microangiopathy were significantly lower than those without microangiopathy (P<0 01). IS in type 2 diabetes with microangiopathy was significantly lower than that without microangiopathy (P<0 001). Multiple stepwise regression analysis showed that type 2 diabetes with microangiopathy was correlated positively with the duration of diabetes and correlated negatively with insulin secretion index.Conclusion These results suggest that type 2 diabetes with microangiopathy has persistent elevated levels of blood sugar. The longer duration of diabetes and insulin secretion deficiency are two main risk factors of type 2 diabetes with microangiopathy.