短期强化降糖序贯胰升血糖素样肽1对新诊断2型糖尿病患者胰岛β细胞功能第一时相分泌的影响

Effects of GLP-1 combined with short-term intensive glycemic control on the first-phase secretion of pancreaticβ-cells in newly diagnosed type 2 diabetic patients

目的探讨胰岛素联合二甲双胍短期强化降糖序贯胰升血糖素样肽1(GLP-1)对新诊断T2DM患者胰岛β细胞功能第一时相分泌的影响。方法 60例新诊断T2DM患者予胰岛素联合二甲双胍强化降糖,使血糖短期内达标(FPG<6.1mmol/L,2hPG<8.0mmol/L)。继续巩固2周后随机分为饮食运动组(n=30)和利拉鲁肽组(n=30)。经过10周的饮食运动及利拉鲁肽干预,比较干预前后胰岛β细胞功能第一时相分泌的变化。结果与饮食运动组比较,利拉鲁肽组FPG水平下降(P<0.05);两组胰岛素、C-P分泌水平升高(P<0.05),但利拉鲁肽组升高更明显,且于4~6min出现峰值(P<0.05);两组胰岛素曲线下面积(AUCIns 0~10min)、C-P曲线下面积(AUCC-P 0~10min)均增加(P<0.05)。结论胰岛素联合二甲双胍短期强化降糖序贯GLP-1可改善T2DM患者胰岛β细胞功能第一时相分泌。

Objective To investigate the effects of GLP-1 treatment after short-term intensive glycemic control with insulin and metformin on the first-phase secretion of pancreaticβ-cells in newly diagnosed type 2 diabetes mellitus（T2 DM）patients. Methods Sixty eligible newly diagnosed T2 DM were recruited and firstly treated with insulin and metformin to accept intensive glycemic control（FPG〈6.1 mmol/L,2 hPG〈8.0 mmol/L）in a short time.After 2 weeks of continuously intensive therapy,T2 DM patients were randomly divided into diet-exercise group（n=30）and liraglutide group（n=30）.After 10 weeks of diet-exercise or liraglutide intervention,the changes of the first-phase insulin secretion before and after intervention were compared. Results The levels of blood glucose significantly decreased in both groups.AUCIns 0~10 minand AUCC-P 0~10 minincreased after diet-exercise intervention,with the same as in Iiraglutide group.Compared with diet-exercise intervention,patients treated with liraglutide accepted better glycemic control and presented first-phase insulin secretion peak in 4~6 min. Conclusion GLP-1 therapy continued to short-term intensive glycemic control with insulin and metformin can significantly improve the first-phase insulin secretion in newly diagnosed T2 DM.