胰岛素泵强化治疗诱导初诊2型糖尿病“蜜月期”性别差异的临床研究

Clinical Study between Gender Differences of Intensive Treatment of Insulin Pump Inducing the "Honeymoon Period" of Newly Diagnosed Type 2 Diabetes

目的:比较胰岛素泵强化治疗诱导初诊2型糖尿病"密月期"在不同性别之间的差异。方法:选取我院2014年5月—2016年12月在我科就诊的240例初诊2型糖尿病患者作为观察对象,按性别不同将其分为男性组和女性组,每组各120例,所有患者均予以胰岛素泵强化治疗3周,均于治疗前、治疗后测定糖负荷后血糖、胰岛素、C肽浓度,以及葡萄糖刺激下的AUC ins(0~180)min、Homa A和Homa B,并进行统计分析。结果:①治疗后男性组患者空腹血糖、胰岛素及C肽改善程度大于女性组患者,差异具有统计学意义(P<0.05);②治疗后男性组患者AUC ins(0~l80)min、Homa A和Homa B改善程度均大于女性组,差异具有统计学意义(P<0.05);③男性组患者诱导成功率为74.17%,女性组患者诱导成功率为59.17%,两组患者比较,男性组胰岛素泵强化治疗诱导初诊2型糖尿病"蜜月期"治疗成功率更高,差异具有统计学意义(P<0.05)。结论:早期胰岛素泵强化治疗可以显著改善初诊2型糖尿病患者的血糖、胰岛素及C肽水平,促进其胰岛素分泌,改善胰岛素抵抗,从而更有效地诱导出初诊2型糖尿病患者的"蜜月期",而在男性初诊2型糖尿病患者中这一作用更为显著,值得临床上推广应用。

Objective:This study is to compare the differences between different genders in the induction of type 2 diabetes mellitus in the intensive treatment of insulin pump.Methods:A total of 240 newly diagnosed type 2 diabetic patients who were admitted to our department since May 2014 to December 2016 were enrolled in the study.They were divided into male and female groups according to the gender,with 120 cases in each group.All patients were treated with intensive insulin pump for 3 weeks,tested for glucose,insulin,C-peptide concentration,and glucose-stimulated AUC ins(0~180)min,Homa A,and Homa B before and after treatment,and statistical analysis was performed.Results:① After treatment,the blood glucose,insulin and C peptide of the two groups were significantly improved compared with before treatment,with the statistically significantdifference(P < 0.05).The improvement of fasting blood glucose,insulin and C peptide in the male group was greater than that of the female group,having the statistical significancedifference(P < 0.05). ② After treatment,the AUC ins(0~180)min,Homa A and Homa B levels of the two groups were better than before treatment,the difference of which was statistically significant(P < 0.05).The male group patients AUC ins(0~180)min,Homa A and Homa B were both greater than that in the female group,also with statistically significantdifference(P < 0.05).Conclusion:Early intensive insulin pump therapy can significantly improve the blood glucose,insulin and C-peptide levels in patients with newly diagnosed type 2 diabetes,promoting insulin secretion and improving insulin resistance,thus more effectively inducing the"honeymoon period"of newly diagnosed type 2 diabetes patients.This effect is more significant in male patients with newly diagnosed type 2 diabetes,which is worthy of further clinical promotion.