初诊2型糖尿病患者短期胰岛素强化治疗的临床观察  

A clinical investigation on short-term intensive insulin therapy in newly diagnosed type 2 diabetes

作　　者：陈明卫[1] 贾敬华[1] 潘天荣[1] 胡红琳[1] 何勇[1] 邓大同[1] 王长江[1] 王佑民[1] 

机构地区：[1]安徽医科大学第一附属医院内分泌科,合肥230032

出　　处：《中国糖尿病杂志》2010年第2期118-120,共3页Chinese Journal of Diabetes

基　　金：安徽省卫生厅临床医学重点学科资助项目(2004Z016)

摘　　要：目的探讨初诊2型糖尿病(T2DM)患者短期胰岛素强化治疗后获长期缓解的影响因素。方法 42例初诊T2DM患者,经2周胰岛素强化治疗后,先给予饮食及运动干预,若血糖不达标,则加用口服降糖药物。追踪观察至少1年。结果 (1)与强化治疗前相比,强化治疗后以及1年后随访的FPG、曲线下葡萄糖面积、HOMA-IR明显降低,曲线下胰岛素面积、△I_(30)/△G_(30)明显增加(P<0.05或P<0.01)。(2)与需口服降糖药物治疗患者相比,单纯饮食控制患者胰岛素强化治疗后FPG、强化治疗停止时胰岛素用量均明显降低,而△I_(30)/AG_(30)则明显增高(P<0.05)。结论短期胰岛素强化治疗可改善糖尿病患者病理生理缺陷。以较低的胰岛素用量能良好控制血糖,β细胞功能得到较好恢复的初诊T2DM者将来获得病情缓解的可能性较大。Objective To explore the influence factors for long-term remission by short-term intensive insulin therapy in newly diagnosed type 2 diabetes（T2DM）. Methods A total of 42 inpatients with newly diagnosed T2DM received a two-week course of insulin therapy. At the begining, diet and exercise therapy were given,if not in good glycemic control, oral hypoglycemic agents（OHA）were given. All patients were followed at least one year. Results （1） In post insulin therapy versus preinsulin therapy group, 1 year follow-up data showed fasting glucose（FPG）, the glucose area under the curve （AUCg）, HOMA-IR were all significantly lower and the insulin area under the curve（AUCi）,△ I30/AG30 were all significantly higher（all P〈0. 05-0.01）. （2） Compared with the subjects of diet therapy alone, the subjects using OHA required less insulin dosage before stopping therapy and were able to attain a lower FPG, a higher AI30/AG30 at the end of intensive insulin therapy were observed （P〈0. 05）. Conclusions The short-term intensive insulin treatment can improve the defect of pathophisiology of diabetes. The subjects with newly diagnosed T2DM might be more easy to have good glucose control with lower insulin dosage and better improvement of β cell secretion function, and have more possibility for long- term remission.

关 键 词：糖尿病 2型 初诊断的 胰岛素强化治疗 

分 类 号：R587.1[医药卫生—内分泌] R587[医药卫生—内科学]