胰岛素强化治疗对2型糖尿病患者血糖状态、高糖毒性及胰岛素分泌功能的影响

Effects of intensive insulin therapy on hyperglycemia,high glucose toxicity and insulin secretion in patients with type 2 diabetes mellitus

目的 探讨胰岛素强化治疗对2型糖尿病(T2DM)患者血糖状态、高糖毒性及胰岛素分泌功能的影响。方法 随机抽取2018年3月至12月商丘市第一人民医院收治的T2DM患者46例为观察组,采用胰岛素强化治疗。另选取同期体检中心健康者42例为对照组。记录并分析两组受试者血糖、糖化血红蛋白(HbA1c)、血脂、脂联素(APN)、胰岛素分泌指数(HOMA-β)等指标。结果 对照组健康者空腹血糖、餐后2 h血糖、HbA1c水平低于治疗前观察组2型糖尿病患者(P<0.05),C肽高于治疗前观察组2型糖尿病患者(P<0.05)。观察组2型糖尿病患者治疗后体质量、体质指数、APN、HOMA-β水平高于治疗前(P<0.05)。对照组健康者[APN(3.9±0.4)mg/L]高于治疗前观察组2型糖尿病患者(t=20.919,P=0.000)。APN水平与空腹血糖、体质指数、三酰甘油呈负相关(r=-0.500、-0.539、-0.642,P均<0.05),与C肽水平呈正相关(r=-0.413,P<0.05)。结论 胰岛素强化治疗T2DM,可缓解患者高血糖状态,解除高糖毒性,改善胰岛素分泌功能。

Objective To investigate the effects of intensive insulin therapy on hyperglycemia,high glucose toxicity and insulin secretion in patients with type 2 diabetes mellitus(T2DM).Methods A total of 46 patients with T2DM admitted to the First People’s Hospital of Shangqiu from March 2018 to December 2018 were selected as the observation group,and they were given intensive insulin therapy.Another 42 healthy people in the same period were selected as the control group.Blood glucose,glycosylated hemoglobin(HbA1c),blood lipids,adiponectin(APN),insulin secretion index(HOMA-β)of the two sroups were recorded and analyzed.Results The blood glucose,2 h postprandial plasma glucose,and HbA1c levels in the control group were lower than those in the observation group before treatment(P<0.05),the C-peptide in the control group was higher than that in the observation group before treatment(P<0.05).The body weight,body mass index,APN and HOMA-βlevels in the observation group with type 2 diabetes were higher than those before treatment(P<0.05).The APN level in the control group was(3.9±0.4)mg/L,higher than that in the observation group before treatment(t=20.919,P=0.000).The APN level was negatively correlated with fasting plasma glucose,body mass index and triacylglycerol(r=-0.500,-0.539,-0.642,P all<0.05),and positively correlated with C-peptide level(r=-0.413,P<0.05).Conclusions Intensive insulin therapy for T2DM can alleviate hyperglycemia,relieve high glucose toxicity and improve insulin secretion.