初诊2型糖尿病患者短期胰岛素强化治疗疗效分析  

Short-term intensive insulin therapy in newly diagnosed type 2 diabetic patients

作　　者：王茜[1] 冯佳庆[1] 沈备[1] 刘超[1] 

机构地区：[1]南京医科大学第一附属医院内分泌科,江苏南京210029

出　　处：《医学研究生学报》2006年第10期915-918,共4页Journal of Medical Postgraduates

基　　金：江苏省135工程重点学科基金资助项目(批准号:苏卫科教[2001]31号)

摘　　要：目的：观察初诊2型糖尿病（DM）患者，应用连续皮下胰岛素输注（CSⅡ）组和皮下多点胰岛素注射（MDI）组强化治疗1个月后血糖、血脂及β细胞功能的变化：方法：初诊2型DM患者38例（CSII组24例，MDI组14例），分别在初诊时和胰岛素（Ins）强化治疗1个月后，测定空腹血糖（FBG）、总胆固醇（CHOL）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL—C）、低密度脂蛋白胆固醇（LDL—C），口服葡萄糖耐量试验（OGIT），胰岛素分泌的曲线下面积（AUCins0-120）和c肽分泌的曲线下面积（AUCc-p0-120min）代表第二时相分泌量，以HOMA模型计算胰岛素抵抗指数（HOMA—IR）和β细胞敏感指数（HOMA—β）。结果：治疗后，两组患者的FBG均获得良好控制，AUCins 0-120min、AUCc-p0-120min、HOMA—β显著改善（P〈0．05）。结论：Ins短期强化治疗可改善初诊2型DM患者的糖代谢、β细胞功能以及Ins敏感性。Objective：To investigate the effect of short-term intensive treatment with insulin on metabolic control, β-cell function and insulin resistance in newly diagnosed type 2 diabetic patients. Methods： Thirty-eight newly diagnosed type 2 diabetic patients were randomly divided into two groups and treated with continuous subcutaneous insulin infusion （CSII） or multiple daily insulin injection （MDI） for 1 month. Fasting blood glucose （FBG） and lipid profiles were measured, and oral glucose tolerance test （OGTT） was performed before and after the treatment. The second phase insulin and C peptide secretions were measured by calculating area under curve （AUC） in OGTT. HOMA model was used to evaluate β- cell function （HOMA-β） and insulin resistance. Results：Excellent control of FBG was achieved after 1 month intensive treatment. HOMA-β was improved significantly. Conclusion .The excellent metabolic control and β-cell function improvement can be achieved by short-term intensive insulin therapies like CSII or MDI.

关 键 词：初诊2型糖尿病 血糖 Β细胞功能 胰岛素抵抗 

分 类 号：R587.1[医药卫生—内分泌]