短期胰岛素强化治疗对新诊断的老年2型糖尿病患者β细胞功能的影响

Effects of Short Term Intensive Insulin Therapy on Beta Cell Function in Newly Diagnosed type 2 Diabetic Patients

目的:探讨短期胰岛素强化治疗对新诊断的老年2型糖尿病患者胰岛β细胞功能及血糖的影响。方法:将80例新诊断的老年2型糖尿病患者,随机分成2组各40例,A组采用胰岛素强化治疗,B组口服药物治疗,分析比较2组治疗前后空腹血糖(FPG),馒头餐2h血糖(2h PG)、糖化血红蛋白(Hb A1c)、空腹胰岛素(FINS)、空腹C肽(FCP)、β细胞胰岛素分泌指数(HOMA-IS)、β细胞胰岛素抵抗指数(HOMA-IR)等指标变化。结果:2组治疗后与本组治疗前比较,FPG、2h PG、HOMA-IR均降低(P<0.01),FINS、FCP、HOMA-IS均升高(P<0.01);治疗后2组间比较,A组FINS、HOMA-IS增高较B组明显(P<0.05);B组HOMA-IR降低较A组明显(P<0.01);2组治疗过程中低血糖发生率无统计学差异(P>0.05)。结论:胰岛素强化降糖治疗可更好的控制老年2型糖尿病患者的血糖水平,改善β细胞功能,不增加低血糖风险。

Objective： To investigate how the short-term intensive insulin treatment influences the function of in- sulin β cells of newly diagnosed elder patients with type 2 diabetes mellitus. Methods ：Eighty newly diagnosed elder patients with type 2 diabetes mellitus were randomly assigned to two groups. Group A was given short-term intensive insulin treatment, and group B Was given oral hypoglycemic agents. The two groups were detected and analyzed with the Fasting plasma glucose （ FPG ）, the plasma glucose level in 2 hours after meal （ 2hPG ）, the HbAlc, the fast- ing insulin （ FINS ）, the fasting C-peptide （ FCP ）, the homeostasis model assessment insulin secrete （ HOMA -IS ）, the homeostasis model assessment for insulin resistance （ HOMA-1R ） and so on before and after treatment . Results ： In group A, after treatment, the levels of FPG, 2hPG, HOMA-IR were decreased （P〈0.01）, while the levels of FINS, CP, HOMA-IS increased obviously （ P〈0.01 ）. In group B, after treatment, the levels of the levels of FPG,2hPG, HOMA-IR were decreased （ P〈O.01 ）, while the levels of FINS, CP, HOMA-IS increased obviously （ P〈0.01 ）. After treatment, compared with group B, the FINS, HOMA-IS of group A wrere increased significant （P〈0.05）, while the HOMA-IR of group A showed a significant decrease （P〈0.01）. Compared with group B, there was no significant dif- ference in the incidence of hypoglycemia of group A （ P〉0.05 ）. Conclusions ：The short-term intensive insulin treat- ment can recover the function of insulin β ceils of newly diagnosed elder patients with type 2 diabetes mellitus, with- out increasing the risk of hypoglycemia.