甘精胰岛素联合二甲双胍治疗对新诊断2型糖尿病伴非酒精性脂肪肝病患者血糖和胰岛β细胞功能的影响

Influence of insulin glargine combined with metformin therapy on glycemic control and pancreatic β-cell function in newly diagnosed patients with type 2 diabetes mellitus companied with non-alcoholic fatty liver disease

目的：探讨甘精胰岛素联合二甲双胍治疗对新诊断2型糖尿病（T2DM）伴非酒精性脂肪肝病（NAFLD）患者血糖和胰岛β细胞功能的影响。方法选取2012年6月～2013年12月在本院内分泌科门诊就诊的62例新诊断T2DM伴NAFLD患者作为研究对象，随机分为治疗组（32例）和对照组（30例）。对照组给予二甲双胍联合格列美脲片，治疗组给予二甲双胍联合甘精胰岛素。比较两组治疗前后的FBG、2 h PG、HbA1c、FINS水平和胰岛β细胞功能指数。结果两组治疗12周后的FBG、2 h PG、HbA1c水平显著低于治疗前，差异有统计学意义（P〈0.05）。两组治疗12周后的FINS、HOMA-βF、△I30/△G30水平显著高于治疗前，差异有统计学意义（P〈0.05）。治疗组治疗后的FINS、HOMA-βF、△I30/△G30水平显著高于对照组治疗后，差异有统计学意义（P〈0.05）。结论甘精胰岛素或格列美脲片联合二甲双胍治疗均能改善T2DM伴NAFLD患者的血糖和早相胰岛素分泌，甘精胰岛素联合二甲双胍治疗能更有效地改善早相胰岛素分泌。

Objective To explore the influence of insulin glargine combined with metformin therapy on glycemic control and pancreatic β-cell function in newly diagnosed type 2 diabetes mellitus （T2DM） patients with non-alcoholic fatty liver disease （NAFLD）. Methods 62 newly diagnosed T2DM patients with NAFLD from June 2012 December 2013 in our hospital were selected and randomly divided into the control group （30 cases） and the treatment group（32cases）. The control group was given metformin plus glimepiride,the treatment group was given metformin plus insulin glargine. The levels of FBG,2 h PG,HbA1c,FINS and the index of β-cell function in two groups before and after treatment was compared. Results The level of FPG,2 h PG,HbA1c after 12 weeks of treatment was lower than that before treatment, with significant difference （P〈0.05）. The level of FINS,HOMA-βF,△I30/△G30 after 12 weeks of treatment was higher than that before treatment,with significant difference （P〈0.05）.The level of FINS,HOMA-βF,△I30/△G30 after treatment in the treatment group was higher than that in the control group after treatment,with significant difference （P〈0.05）. Conclu-sion Insulin glargine or glimepiride combined with metformin can effectively improve glycemic control and early phase insulin secretion in newly diagnosed T2DM patients with NAFLD,insulin glargine combined with metformin can more effectively improve early phase insulin secretion.