不同胰岛素联合治疗对2型糖尿病患者胰岛细胞功能的影响

Effects of different insulin therapies on islet cell function in patients with type 2 diabetes mellitus

目的探讨不同胰岛素联合治疗对2型糖尿病患者胰岛细胞功能的影响。方法选择50例2型糖尿病患者,根据用药方式不同分为观察组和对照组各25例。对照组予以门冬胰岛素联合甘精胰岛素治疗,观察组采用门冬胰岛素联合地特胰岛素治疗,疗程均为3个月。比较两组治疗前后空腹胰岛素、餐后2 h胰岛素、C肽、糖化血红蛋白(Hb A1c)及果糖胺等水平变化情况。结果两组患者治疗前空腹、餐后2 h的C肽及胰岛素指标比较差异均无统计学意义(P>0.05),治疗后空腹胰岛素及C肽水平均显著上升(P<0.05),观察组餐后2 h胰岛素水平与治疗前相比明显升高,也显著高于对照组,差异均有统计学意义(P<0.05)。与治疗前相比,治疗后两组患者Hb A1c、果糖胺水平均显著下降,差异均有统计学意义(P<0.05)。结论 2型糖尿病患者采用门冬胰岛素联合地特胰岛素治疗可明显改善患者的胰岛素细胞功能,与门冬胰岛素联合甘精胰岛素治疗相比治疗效果更佳,应用价值更高。

Objective To investigate the effects of different insulin treatments on islet cell function in the patients with type 2 diabetes mellitus. Methods Fifty patients with type 2 diabetes were divided into the observation group and the control group according to the different treatment methods,with 25 cases in each group. The control group was given insulin aspart combined with insulin glargine and the observation group was treated with insulin aspart combined with insulin detemir. Both of the two treatments lasted for 3 months. The levels of fasting insulin,postprandial 2 h insulin,C peptide,Hb A1 c and fructosamine were compared between the two groups. Results There were no significant differences in the levels of fasting and postprandial 2 h C peptide and insulin indexes between the two groups before the treatment（ P 0. 05）; The levels of fasting insulin and C peptide were significantly increased in both of the two groups after the treatment（ P 0. 05）; The level of 2-hour postprandial insulin in the observation group was significantly increased compared with that before the treatment,and significantly higher than that of the control group（ P 0. 05）. Compared with those before the treatment,the levels of Hb A1 c and fructosamine were significantly decreased in both of the two groups（ P 0. 05）. Conclusion Insulin aspart combined with insulin detemir can significantly improve the islet cell function and is more effective than insulin aspart combined with insulin glargine in the treatment for the patients with type 2 diabetes.