短期胰岛素泵强化治疗对2型糖尿病患者脂糖代谢及胰岛β细胞功能的影响

Effect of Intensive Treatment of Short-term Insulin Pump on Glycolipid Metabolism and Islet β-cell Function for the Patients with Type 2 Diabetic Mellitus

目的:探讨短期胰岛素泵强化治疗对2型糖尿病患者脂糖代谢及胰岛β细胞功能的影响。方法:选择2013年10月到2015年10月我院收治的2型糖尿病患者86例,随机分为对照组(n=43)和实验组(n=43)。对照组患者给予门冬胰岛素常规治疗,实验组患者给予胰岛素泵强化治疗,两组疗程均为2周。检测并比较两组患者治疗前后血糖、血脂、糖化血红蛋白(Hb A1c)及口服葡萄糖刺激后胰岛β细胞功能指标。结果:治疗后两组患者空腹血糖(FPG)、Hb A1c、总胆固醇(TC)、甘油三酯(TG)及低密度脂蛋白胆固醇(LDL-C)、稳态模型评价-胰岛素抵抗(HOMA-IR)较治疗前均明显下降(P<0.05),高密度脂蛋白胆固醇(HDL-C)、胰岛素曲线下面积(AUC)、稳态模型评价-胰岛β细胞功能(HOMA-β)及0.5h胰岛素浓度/血糖浓度(I30/G30)较治疗前明显升高(P<0.05),且实验组患者以上各指标变化均优于对照组(P<0.05)。结论:短期胰岛素泵强化治疗能明显纠正2型糖尿病患者血糖、血脂水平,改善胰岛β细胞功能,值得在临床上推广应用。

Objective： To study the effect of intensive treatment of short-term insulin pump on glycolipid metabolism and isletβ-cell function for the patients with type 2 diabetic mellitus. Methods： A total of 86 patients with type 2 diabetic mellitus in our hospital from October 2013 to October 2015 were enrolled, they were divided into control group（n=43） and experiment group（n=43） randomly.The control group were treated with insulin aspart conventional therapy, while the experiment group were treated with intensive treatment of short-term insulin pump, the course of treatment was 2 weeks in two groups. The plasma glucose, blood lipid, glycosylated hemoglobin（Hb A1c） and the indexes of islet β-cell function after oral glucose stimulation were detected and compared in two groups before and after treatment. Results： After treatment, the levels of fasting plasma glucose（FPG）, Hb A1 c, total cholesterol（TC）, triglyceride（TG）, low density lipoprotein cholesterol（LDL-C）and Homeostasis model assessment-IR（HOMA-IR）in two groups significantly cut down than before treatment（P〈0.05）, but the high density lipoprotein cholesterol（HDL-C）, insulin area under the curv（AUC）, homeostasis model assessment-β（HOMA-β）and insulin concentration/blood glucose concentration at 0.5 h（I30/G30）in two groups significantly increased than before treatment（P〈0.05）,furthermore, above indexes in experiment group changed significantly better than control group（P〈0.05）. Conclusion： The intensive treatment of short-term insulin pump can obviously correct the levels of plasma glucose, blood lipid and improve the islet β-cells function for the patients with type 2 diabetic mellitus, which is worthy application in clinic.