摘要
目的观察短期胰岛素强化治疗对新诊断2型糖尿病患者胰岛功能及胰岛素敏感性的影响。方法入组90例新诊断2型糖尿病患者,在不同日行静脉葡萄糖耐量试验（IVGTT）及口服葡萄糖耐量试验（OGTT）,完成检查后予胰岛素泵持续皮下输注胰岛素治疗（CSII）,血糖达标后维持10-14 d,复查相关指标。胰岛功能指标包括IVGTT胰岛素曲线下面积（AUCIns）、OGTT胰岛素曲线下面积（AUCIns）、IVGTT急性胰岛素分泌（AIR3-5）、OGTT早期相胰岛素分泌指数（ΔIns30/ΔG30）、β细胞功能评定指数（MBCI）和稳态模型评估法（HOMA-B）等。胰岛素敏感性指标采用稳态模型评估法（HOMA-IR）、胰岛素敏感性指数（IAI）、定量胰岛素敏感性检测指数（QUICKI）及Cederholm的胰岛素敏感性指数ISIced等。结果治疗后IVGTT及OGTT中AUCIns均较治疗前升高,差异有统计学意义（P〈0.001）;AIR3-5、ΔIns30/ΔG30、MBCI及HOMA-β均较治疗前升高,差异均有统计学意义（P〈0.001）;调整胰岛素抵抗影响后,上述结果不变。治疗后HOMA-IR较治疗前降低,差异有统计学意义（P〈0.001）;ISIced、IAI、QUICKI均较治疗前升高,差异均有统计学意义（P〈0.001）。结论短期胰岛素强化治疗可显著改善新诊断2型糖尿病患者的胰岛功能,增强胰岛素敏感性。
OBJECTIVE To investigate the effect of intensive insulin treatment on β cell function and insulin sensibility in patients with newly diagnosed type 2 diabetes. METHODS Ninety patients with newly diagnosed type 2 diabetes were enrolled.Intravenous glucose tolerance tests（ IVGTT） and oral glucose tolerance tests（ OGTT） were carried out on these patients in different days. After that,all patients received the continuous subcutaneous insulin infusion（ CSII） with insulin pump. The treatment continued for more 10-14 d after blood glucose reached the standard. All the indicators were reviewed after treatment. β cell function was measured by IVGTT AUCIns,OGTT AUCIns,AIR3-5,△Ins30/ △G30,MBCI and HOMA-β. Insulin resistance was evaluated by HOMA-IR,IAI,QUICKI and ISIced. RESULTS AUCInsof IVGTT and OGTT,AIR3-5,ΔIns30/ ΔG30,MBCI and HOMA-β were all statistically increased after treatment（ P〈0.001）. After regulating the influence of insulin resistance,their changes remained the same（ P〈0.001）.As to insulin resistance,HOMA-IR was lower while ISIced,IAI and QUICKI were higher after treatment（ P〈0.001）. CONCLUSION Short-term intensive insulin therapy for patients with newly diagnosed type 2 diabetes will significantly improve their β cell function and insulin sensitivity.
出处
《今日药学》
CAS
2016年第1期22-26,共5页
Pharmacy Today
基金
广东省药学会科学研究基金项目(2012C11)
