早期胰岛素强化联合不同治疗方案对新诊断T2DM的效果

Effect of Early Insulin Intensive Combined with Different Treatment Schemes on Newly Diagnosed Type 2 Diabetes Patients

目的探究早期胰岛素强化治疗后给予不同治疗方案对新诊断2型糖尿病(T2DM)患者的治疗效果。方法选择我院2019年3~12月新诊断62例T2DM患者作为研究对象,按照随机数字表法分为基础胰岛素(Bal)组21例、预混胰岛素(Prx)组21例、磺脲类促胰岛素分泌剂(Sus)组20例,行早期胰岛素强化治疗后按照上述三种不同方案进行治疗,比较三组空腹血糖(FPC)、空腹C肽水平及胰岛β细胞功能(HOMA-β)、胰岛素抵抗指数(HOMA-IR)。结果强化治疗前,三组FPC、空腹C肽水平比较,差异无统计学意义(P>0.05);治疗后,Sus组FPC水平低于Bal组、Prx组,空腹C肽水平高于Bal组、Prx组,差异有统计学意义(P<0.05);Sus组HOMA-β高于Bal组、Prx组,HOMA-IR低于Bal组、Prx组,差异有统计学意义(P<0.05)。结论新诊断T2DM患者在胰岛素强化治疗后使用格列齐特缓释片等磺脲类促胰岛素分泌剂进行后续治疗可以更有效地改善患者的血糖水平和胰岛β细胞功能。

Objective To explore the therapeutic effects of different treatments after early intensive insulin therapy on newly diagnosed type 2 diabetes(T2DM)patients.Methods 62 newly diagnosed T2DM patients in our hospital from March to December 2019 were selected as the research objects.According to the random number table,they were divided into 21 cases in the basal insulin(Bal)group,21 cases in the premixed insulin(Prx)group,and sulfonylureas.20 patients in the insulin secretion agent(Sus)group were treated with the above three different regimens after early intensive insulin therapy.The three groups were compared with fasting blood glucose(FPC),fasting C-peptide levels,islet β-cell function(HOMA-β),and insulin resistance index(HOMA-IR).Results Before intensive treatment,there was no significant difference in FPC and fasting C-peptide levels among the three groups(P>0.05);after treatment,FPC levels in Sus group were lower than Bal and Prx groups,and fasting C-peptide levels were higher than Bal and Prx Group,the difference was statistically significant(P<0.05);Sus group HOMA-β was higher than Bal group and Prx group,HOMA-IR was lower than Bal group,Prx group,the difference was statistically significant(P<0.05).Conclusion The use of sulfonylurea insulin secretagogues such as Gliclazide sustained-release tablets for subsequent treatment of newly diagnosed T2DM patients after intensive insulin therapy could more effectively improve the patient's blood glucose level and pancreaticβ-cell function.