维生素A联合地特胰岛素-门冬胰岛素降糖方案对糖尿病患儿糖脂代谢和胰岛素抵抗的影响

Effect of Vitamin A Combined with Insulin Detemir-Insulin Aspart Hypoglycemic Regimen on Glycolipid Metabolism and Insulin Resistance in Children with Diabetes

目的:分析维生素A联合地特胰岛素-门冬胰岛素降糖方案对糖尿病患儿糖脂代谢和胰岛素抵抗的影响,为临床应用提供参考。方法:选择我院2019-2021年收治的114例1型糖尿病患儿随机分为观察组和对照组各57例,对照组给予地特胰岛素+门冬胰岛素治疗,观察组给予地特胰岛素+门冬胰岛素联合维生素A治疗,两组患儿均持续治疗12周作为治疗后观察时间点,比较两组患儿残存胰岛β细胞功能、糖脂代谢、氧化应激水平、血糖达标时间、胰岛素日用量、低血糖发生情况、并发症发生情况。结果:治疗后观察组胰岛β细胞功能指数(HOMA-β)、低密度脂蛋白胆固醇(HDL-C)、一氧化氮(NO)、超氧化物歧化酶(SOD)水平高于对照组,胰岛素抵抗指数(HOMA-IR)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)、丙二醛(MDA)水平及尿液中8-羟基脱氧鸟苷(8-OhdG)和8-异前列腺素(8-iso-PGF2α)水平低于对照组(P<0.05);治疗后观察组低血糖发生率低于对照组,且低血糖患儿中的低血糖发生次数低于对照组,而低血糖水平高于对照组(P<0.05);治疗后观察组血糖达标时间、门冬胰岛素及地特胰岛素的总胰岛素日用量均低于对照组(P<0.05);治疗后观察组视网膜病变、蛋白尿、肝炎等发生率均低于对照组(P<0.05)。结论:维生素A联合地特胰岛素-门冬胰岛素降糖方案可显著改善糖尿病患儿糖脂代谢和胰岛素抵抗状态,具有较高的应用价值。

Objective:To analyze the effect of vitamin A combined with insulin detemir-insulin aspart on glycolipid metabolism and insulin resistance in children with diabetes,and provide basis for clinical application.Methods:A total of 114 children with type 1 diabetes admitted to our hospital from 2019 to 2021 were divided into observation group and control group in average.The control group was treated with insulin detemir+insulin aspartate,and the observation group was treated with insulin detemir+insulin aspartate combined with vitamin A.Both groups were treated for 12 weeks as the observation time point after treatment.The function of residual pancreaticβcells,glycolipid metabolism,oxidative stress level,blood glucose target time,total daily dosage of insulin,occurrence of hypoglycemia and occurrence of complications were compared between the two groups.Results:After treatment,HOMA-β,HDL-C,NO and SOD of observation group were significantly higher than those of control group,while HOMA-IR,TG,TC,LDL-C,FPG,MDA,8-OhdG and 8-iso-PGF2αof observation group were significantly lower than those of control group(P<0.05).After treatment,the incidence of hypoglycemia in the observation group was lower than that in the control group,and the incidence of hypoglycemia in the patients with hypoglycemia was lower than that in the control group,while the level of hypoglycemia was higher(P<0.05).After treatment,the blood glucose reaching time,the total daily dosage of insulin aspartate and insulin detemir in observation group were significantly lower than those in control group(P<0.05).After treatment,the incidence of retinopathy,albuminuria and hepatitis in observation group was lower than that in control group,and there was statistical significance(P<0.05).Conclusion:Vitamin A combined with insulin detemir-insulin aspart can significantly improve glycolipid metabolism and insulin resistance in children with diabetes after intervention,which has high application value.