胰岛素强化治疗高龄隐匿性自身免疫性糖尿病的疗效及对胰岛β细胞功能的影响

Curative Effect of Intensive Insulin Therapy for Elderly LADA Patients and Its Impact on HOMA-β

目的探讨成人隐匿性自身免疫性糖尿病(LADA)高龄患者进行胰岛素强化治疗的临床效果及对胰岛β细胞功能的影响。方法选取高龄LADA患者100例,随机分为两组各50例,对照组进行二甲双胍与利拉鲁肽联合疗法,观察组在此基础上予以胰岛素强化疗法,比较两组治疗前后的糖化血红蛋白(HBAlc)、餐后2 h血糖(2h PG)、空腹血糖(FPG)、胰岛β细胞功能指数(HOMA-β)、空腹C肽、餐后2 h C肽等指标,以及治疗后的并发症发生情况。结果观察组治疗后的HBAlc、2h PG、FPG均显著低于对照组(P<0.01),HOMA-β、空腹C肽、餐后2 h C肽水平均显著高于对照组(P<0.01)。观察组治疗后的并发症的发生率显著低于对照组(P<0.01)。结论高龄LADA患者采用胰岛素强化疗法,可显著改善其胰岛β细胞功能以及血糖波动情况,临床效果确切,值得临床推广。

Objective To explore the clinical effect of intensive insulin therapy for elderly patients with latent autoimmune diabetes in adults （LADA） and its impact on HOMA-β. Methods A total of 100 cases of elderly LADA patients were selected and randomly divided into two groups, with 50 cases in each group. The control group was treated with metformin and liraglutide, while the observation group received intensive insulin therapy additionally. The levels of HBAIc, 2hPG, FPG, HOMA-β, fasting C-peptide and 2-hour postprandial C-peptide before and after therapy, and complications after therapy were observed and compared between two groups. Results After therapy, the levels of HBAlc, 2hPG and FPG of observation group were significantly lower than those of control group, and the levels of HOMA-β, fasting C-peptide and 2-hour postprandial C-peptide were significantly higher than those of control group （P〈0.01）. The incidence of complications of observation group was significantly lower than that of control group （P 〈0.01）. Conclusions Intensive insulin therapy for elderly LADA patients has significant clinical efficacy, which can effectively improve patients＇ islet β cell fimction and glycemic fluctuation.