不同强化方案对初诊2型糖尿病治疗效果的比较  

Comparison of the effect of different short-term intensive anti-diabetic therapies on newly diagnosed type 2 diabetic patients.

作　　者：王茜[1] 徐宽枫[1] 刘翠萍[1] 覃又文[1] 茅小东[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,南京210029

出　　处：《中国实用内科杂志》2008年第11期930-933,共4页Chinese Journal of Practical Internal Medicine

基　　金：江苏省政府医学重点学科资助项目(2001-34)

摘　　要：目的比较初诊2型糖尿病患者使用胰岛素、胰岛素联合口服降糖药和单纯口服降糖药联合强化治疗对患者血糖、血脂、B细胞功能和胰岛素敏感性的影响。方法将2005年3月至2006年4月南京医科大学第一附属医院内分泌科48例空腹血糖(FBG)7.0～11.0 mmol/L的初诊2型糖尿病患者随机分为3组,第1组(12例)实行单纯胰岛素治疗,第2组(20例)采用甘精胰岛素联合二甲双胍治疗,第3组(16例)接受格列美脲和二甲双胍联合治疗,分别在诊断初和强化治疗3个月时行口服葡萄糖耐量试验(OGTT),并测定FBG、餐后血糖(PBG)、糖化血红蛋白(HbA1c)以及血脂,15例患者加测静脉葡萄糖耐量试验(IVGTT)。结果治疗后,患者的血糖、血脂及B细胞功能均明显改善;单纯胰岛素治疗组HbA1c降低更为显著。结论3个月后3组强化治疗方案均可以改善初诊2型糖尿病患者的糖脂代谢、B细胞功能以及胰岛素敏感性,单纯使用胰岛素治疗方案使糖代谢异常的改善更为明显。Objective To compare the effect of different short-term intensive treatments with insulin or mefformin and glargine or metformin and glimepiride on metabolic control, B-cell function and insulin sensitivity in newly diagnosed type 2 diabetic patients. Methods From March 2005 to April 2006,48 newly diagnosed type 2 diabetic patients with fasting plasma glucose（FBG） of 7.0 - 11.0 mmol/L were randomly divided into three groups. The patients were treated with insulin or glargine and mefformin or glimepiride and metformin for 3 months, respectively. FBG, postprandial blood glucose （PBG） ,haemoglobin A1c（ HbA1c） and lipid profiles were measured, and oral glucose tolerance test（OGTT） was performed before and after the treatment. Fifteen patients received intravenous glucose tolerance test （IVGrlT）. Results There showed excellent control of blood-glucose ; blood-fat and B-cell function were improved significantly. Patients treated with insulin alone had greatest decrease in terms of HbA1 c when compared with the other two groups. Conclusion Excellent metabolic control and B-cell function and insulin sensitivity improvement can be achieved with three short-term intensive anti-glycemic strategies, esp. with insulin treatment regimen.

关 键 词：2型糖尿病 血脂 B细胞功能 胰岛素抵抗 

分 类 号：R5[医药卫生—内科学]