影响新诊断2型糖尿病患者短期胰岛素强化治疗后无药缓解的相关因素研究

Study on relevant factors influencing medicine-free remission rate after short-term continuous subcutaneous insulin infusion in newly diagnosed patients with type 2 diabetes metillus

目的分析新诊断2型糖尿病人短期胰岛索强化治疗后临床无药缓解的相关因素。方法选取本院2003年10月一2012年10月住院的新诊断2型糖尿病人405例为研究对象,所有患者接受15 d胰岛素泵(CSII)强化治疗后,按其出院时是否需要降糖药物治疗分为成功组(165例)和失败组(240例),分析2组患者年龄、体质量指数(BMI)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、2hC肽与空腹C肽的比值(C_2/C_0)、强化治疗期间血糖达标的时间及全天胰岛素用量等指标与新诊断2型糖尿病人经短期强化治疗后临床无药缓解之间的关系。结果成功组患者的FPG、HbA1c、强化治疗期间胰岛素用量低于失败组,C_2/C_0明显高于失败组,差异有显著统计学意义(P<0.01)。结论 FPG、HbA1c、C_2/C_0可作为新诊断2型糖尿病患者胰岛素强化治疗的筛选指标。FPG、HbA1c低、C_2/C_0高者更适宜尽早给予胰岛素强化治疗,从而诱导临床长期缓解。

Objective To analyze the relevant factors that influence the medicine-free re-mission rate after short-term continuous subcutaneous insulin infusion （CSII）in newly diagnosed patients with type 2 diabetes metillus （T2DM）.Methods A total of 405 patients with T2DM hos-pitalized in our hospital from October 2003 to October 2012 served as the study objects,who were given CSII for 15 d and divided into success group （165 cases）and failure group （240 cases）based on the requirement of hypoglycemic agents after discharge from hospital.The relationship between ages,genders,body max index （BMI）,fasting plasma glucose （FPG）,glycated hemoglobin （HbA1c）,ratio of 2 h C-peptide and fasting peptide （C2 /C0）,attained time of plasma glucose and daily dosage of insulin during CSII with the clinical medicine-free remission rate after short-term CSII in patients with T2MD.Results Success group was evidently lower in FPG,HbA1c and daily dosage of insulin but obviously higher in C2 /C0 during CSII than failure group,and the differences were all statistically significant （P 〈0.01）.Conclusion FPG,HbA1c and C2 /C0 can be used as the screening indexes for the diagnosis of T2DM patients treated with CSII,and T2DM patients with low FPG and HbA1c and high C2 /C0 are more suitable and should given CSII earlier so as to induce longer-term remission rate in clinic.