早期胰岛素泵强化治疗新诊断2型糖尿病对胰岛B细胞功能及血糖达标时间的影响

The Effects of Early Insulin Pump Intensive Therapy in Newly Diagnosed Type 2 Diabetes on the Islet B Cell Function and Blood Glucose Standard Time

目的:探讨早期短期应用胰岛素泵强化治疗新诊断2型糖尿病对胰岛B细胞功能及血糖达标时间的影响。方法:选取本院2012年8月-2014年8月就诊的50例新诊断2型糖尿病患者,按照随机数字表法将其分为观察组和对照组,每组25例。对照组采用胰岛素笔多次注射胰岛素治疗(于患者三餐前皮下注射优泌林R加22时皮下注射优泌林N),观察组采用美国美敦力胰岛素泵持续皮下输注胰岛素(基础量加餐前大剂量),治疗2周后,观察并比较两组患者治疗前后空腹血糖、餐后2 h血糖、空腹C肽以及血糖达标时间。以C肽水平评估胰岛B细胞功能情况。结果:两组患者治疗后的空腹血糖(FPG)、餐后2 h血糖(2 h PG)均明显低于治疗前,空腹C肽均明显高于治疗前,差异均有统计学意义(P<0.05)。而两组患者治疗后的FPG、2 h PG比较差异均无统计学意义(P>0.05),观察组治疗后的空腹C肽明显高于对照组,差异有统计学意义(P<0.05)。观察组患者的血糖达标时间(156.44±13.20)h明显短于对照组的(204.96±19.06)h,差异有统计学意义(t=-10.462,P<0.05)。结论:胰岛素泵连续皮下输注能够明显改善新诊断2型糖尿病患者胰岛B细胞分泌功能,并能使血糖平稳及更快达标,值得临床推广。

Objective：To investigate the effects of early insulin pump intensive therapy in newly diagnosed type 2 diabetes on the islet B cell function and blood glucose standard time.Method：Fifty cases of newly diagnosed type 2 diabetes admitted to our hospital from August 2012 to August 2014 were selected and divided into the observation group and the control group according to the random number table method,25 cases in each group.The control group was given insulin pen multiple injections of insulin therapy（Humulin R was injected in patients by subcutaneous before meals plus Humulin N was injected at 22∶00 by subcutaneous）,the observation group was given Medtronic insulin pump continuous subcutaneous insulin infusion（basic amount plus high-dose fasting）.After 2 weeks of treatment,the fasting blood glucose,2 h postprandial glucose,fasting C-peptide between the two groups before and after treatment were observed and compared,and the blood glucose time of the two groups was compared.The situation of islet B cell function was assessed by C-peptide levels.Result：After treatment,the fasting blood glucose,2 h postprandial glucose of the two groups were significantly lower than before treatment,the fasting C-peptide of the two groups were significantly higher than before treatment,the differences were statistically significant（P〈0.05）.There were no statistically significant differences in the fasting blood glucose,2 h postprandial glucose between the two groups after treatment（P〉0.05）.The fasting C-peptide of the observation group was significantly higher than the control group,the difference was statistically significant（P〈0.05）.The blood glucose standard time of the observation group was（156.44±13.20）h,which was significantly shorter than（204.96±19.06）h of the control group,the difference was statistically significant（t=-10.462,P〈0.05）.Conclusion：Continuous subcutaneous insulin infusion pump can significantly improve cell secretion in newly diagnosed type 2 diabetic patients with B cell function,and can make blood glucose stable and faster compliance,is worthy of clinical promotion.