胰岛素对初发2型糖尿病患者胰岛β细胞功能和胰岛素抵抗的影响  

The effects of insulin treatment on islet β cell function and insulin resistance in newly diagnosed type 2 diabetic patients

作　　者：王德峰[1] 宋光耀[1] 孙力[2] 刘景广[2] 杨丁贵[2] 

机构地区：[1]河北医科大学,河北石家庄050017 [2]河北工程大学附属医院

出　　处：《中国老年学杂志》2008年第3期271-273,共3页Chinese Journal of Gerontology

基　　金：河北省卫生厅基金资助(06061)

摘　　要：目的观察胰岛素对初发2型糖尿病患者胰岛β细胞功能和胰岛素抵抗的影响。方法将120例空腹血糖≥11.1mmol/L的初发2型糖尿病患者随机分为胰岛素组、格列齐特组、二甲双胍组和吡格列酮组,在饮食及运动治疗的基础上,给予不同的药物治疗3个月,比较各组治疗前后空腹血糖(FBG)、餐后2h血糖(PBG2h)、糖化血红蛋白(HbA1c)、胰岛素糖负荷后曲线下面积(AUCi)、C肽糖负荷后曲线下面积(AUCcp)、胰岛素分泌指数(Homa-β)和胰岛素抵抗指数(Homa-IR)的变化。结果12w治疗后,胰岛素组的胰岛素AUC0-30min、C肽AUC0-30min、Homa-β水平均高于3个口服降糖药组,差别具有统计学意义(P<0.05);且在治疗后胰岛素组的Homa-IR低于格列齐特组(P<0.05),而与二甲双胍组和吡格列酮组无显著性差异。结论对初发2型糖尿病患者,早期胰岛素治疗比常规的口服降糖药可更好地改善胰岛β细胞功能和胰岛素抵抗。Objective To explore the effects of insulin treatment on islet β cell function and insulin resistance in newly-diagnosed type 2 diabetes mellitus （T2DM） patients. Melhods The 120 newly diagnosed T2DM patients, whose FBG≥11. 1 ramol/L, were divided into insulin, gliclazide, dimethylbiguanide and pioglitazone groups （ each group n = 30）. After three months treatment, the changes of FBG, PBG, HbAlc, AUCi, AUCcp, Homa-13and Homa-IR in different groups were compared. Results After 12 weeks of the treatment, the in sulin AUC0 - 30 min, C peptide AUC0 - 30 min and Homa-β in insulin group were higher than those in the other three groups （ P 〈 0. 05 ）. Homa-IR in insulin group was lower than that in gliclazide group （ P 〈 0. 05）, but was not different from that in dimethylbiguanide and pioglitazone groups （P 〉 0. 05 ）. Conclusions The method of early insulin treatment can effectively improve islet β cell function and insulin sensitivity in newly diagnosed T2DM patients comparing with oral antidiabetic drug.

关 键 词：2型糖尿病 胰岛素 口服降糖药 胰岛素抗药性 

分 类 号：R589.1[医药卫生—内分泌]