新诊断2型糖尿病早期胰岛素强化治疗后3种治疗方案对胰岛β细胞功能及胰岛素抵抗的影响评价

Evaluation of the Effects of Three Treatment Options on Pancreaticβ-cell Function and Insulin Resistance after Early Intensive Insulin Therapy for Newly Diagnosed Type 2 Diabetes

目的研究分析新诊断2型糖尿病早期胰岛素强化治疗后3种治疗方案对胰岛β细胞功能及胰岛素抵抗的影响。方法选择该院于2019年1—12月期间收治的120例2型糖尿病患者为该次研究对象,予以早期胰岛素强化治疗,二甲双胍口服,后将其随机分为A、B、C3组,各40例,A组采用基础胰岛素类似物治疗,B组采用预混胰岛素类似物治疗,C组采用磺脲类促胰岛素分泌剂治疗,均治疗1年,观察治疗前后FPG、2 h PG、Hb A1c指标,计算HOMA-IR、AIR、HOMA-β等,并对数据进行分析统计。结果治疗后3组FPG、2 h PG和Hb A1c较治疗前均明显下降,差异有统计学意义(P<0.05),治疗后A、B两组之间HOMA-IR、AIR、HOMA-β指标比较差异无统计学意义(P>0.05),3组间HOMA-IR对比差异无统计学意义(P>0.05),A、B组的AIR、HOMA-β的恢复均高于C组,差异有统计学意义(P<0.05)。结论针对新诊断的2型糖尿病患者,采用早期胰岛素强化治疗后,选择含胰岛素的治疗方案效果更为显著,其胰岛β细胞的功能改善更为明显。

Objective To study and analyze the effects of three treatment options on pancreaticβ-cell function and insulin resistance after intensive insulin therapy for newly diagnosed type 2 diabetes.Methods A total of 120 patients with type 2 diabetes who were admitted to the hospital from January to December 2019 were selected as the subjects of this study.They were given early intensive insulin therapy and oral metformin,and then they were randomly divided into three categories:A,B,and C groups,40 cases in each group,group A was treated with basal insulin analogues,group B was treated with premixed insulin analogues,and group C was treated with sulfonylurea insulin secretagogues.Both were treated for 1 year.Observe FPG,2 hPG,HbA1c indicators before and after treatment,calculate HOMA-IR,AIR,HOMA-β,etc.,and analyze the data.Results After treatment,FPG,2 hPG and HbA1c in the three groups were significantly lower than before treatment,the difference was statistically significant(P<0.05).After treatment,there was no significant difference in HOMA-IR,AIR,and HOMA-βbetween A and B groups,the difference was not statistically significant(P>0.05).There was not significant difference in HOMA-IR comparison between the three groups(P>0.05).The recovery of AIR and HOMA-βin groups A and B were higher than those in group C,the difference was statistically significant(P<0.05).Conclusion For newly diagnosed type 2 diabetic patients,after early intensive insulin therapy,the effect of choosing insulin-containing treatment plan is more significant,and the function of pancreaticβ-cells is improved more significantly.