胰岛素强化治疗对初诊2型糖尿病患者胰岛B细胞功能、血清超敏C反应蛋白及血糖血脂代谢的影响

The Effect of The First Diagnosis in Patients with Type 2 Diabetes' Islet B Cell Function、Serum Hypersensitive C-reactive Protein and Metabolism of Glucose and Lipid by Insulin Intensive Therapy

目的探讨胰岛素短期强化治疗对初诊2型糖尿病(T2DM)患者血糖血脂代谢、胰岛B细胞功能及血清超敏C反应蛋白(hs-CRP)的影响。方法选取2013年9月—2016年9月于该科初次诊断且接受胰岛素短期强化治疗的100例T2DM患者作为研究对象,在控制饮食、运动疗法基础上采用胰岛素强化治疗(三短一长)。治疗前和停止胰岛素强化治疗后测定患者FBG、餐后2 h血糖(2 h PBG)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDLC)、低密度脂蛋白胆固醇(LDL-C)、空腹胰岛素(FINS)、餐后1 h和2 h胰岛素(INS1、INS2)、胰岛B细胞分泌指数(Homa-IS)、胰岛素抵抗指数(HOMA-IR)及血清hs-CRP水平。结果胰岛素短期强化治疗2周后患者的FBG、2 h PBG、TC、TG、LDL-C及hs-CRP水平均显著低于治疗前,HDL-C水平明显高于治疗前,差异有统计学意义(P<0.05);胰岛素短期强化治疗2周后患者的FINS、INS1、INS2及Homa-IS、均明显高于治疗前,HOMA-IR明显低于治疗前,差异有统计学意义(P<0.05)。结论对于初诊断的2型糖尿病患者,起始胰岛素短期强化治疗,能显著降低血糖血脂,改善代谢紊乱,恢复胰岛B细胞功能,改善胰岛素抵抗,降低血清hs-CRP水平,作为初诊断2型糖尿病患者的主要治疗方法,有助于延缓糖尿病进展、减少并发症的发生、发展。

Objective Objective to investigate the effects of short-term intensive insulin therapy on blood glucose and lipid metabolism, islet beta cell function and serum high sensitivity C reactive protein （ hs-CRP） in newly diagnosed type 2 dia-betes mellitus （ T2DM）. Methods From September 2013 to September 2016 in our department and accept the initial diagno-sis of short-term intensive insulin therapy in 100 cases of T2DM patients as the research object, in the control diet and ex-ercise therapy based on the use of intensive insulin therapy （three short long）. Stop before treatment and after intensive insulin therapy in patients with FBG, 2 h postprandial blood glucose（2 hPBG）, total cholesterol （ TC）, three glycerol （ TG）, high density lipoprotein cholesterol （ HDL-C）, low density lipoprotein cholesterol （ LDL-C）, fasting insulin （ FINS）, postprandial 1 h and 2 h insulin （ INS1, INS2）, insulin secretion index （ Homa-IS） and insulin resistance index （ HOMA-IR） and serum hs- CRP level. Results The treatment was significantly lower than that of short-term intensive insulin treatment in patients after 2 weeks of FBG, 2h PBG, TC, TG, LDL-C and hs-CRP level, HDL-C level was significantly higher than that before treat-ment, the differences were statistically significant （ P 〈0.05）; short term intensive insulin treatment in patients after 2 weeks of FINS, INS1, INS2 and Homa-IS, were was significantly higher than before treatment, HOMA-IR was significantly lower than that before treatment, the differences were statistically significant （ P〈0.05）. Conclusion For the early diagnosis of type 2 diabetes mellitus patients, short-term intensive treatment initiation of insulin, can significantly reduce blood sugar, im-prove metabolism, recovery of islet B cell function, improve insulin resistance, reduce serum hs-CRP levels, as the main method for the treatment of newly diagnosed patients with type 2 diabetes mellitus, helps to delay the progression to dia-betes, reduce the incidence of complications. The development of.