不同疗程胰岛素强化治疗对口服降糖药失效的糖尿病患者胰岛β细胞功能的保护作用  

The effect of different courses of intensive insulin therapy on protection of pancreatic β-cell function in oral hypoglycemic agents failed diabetes

作　　者：叶礼红[1] 谭劼[2] 徐晓华[3] 孙辽[1] 

机构地区：[1]中山大学附属第五医院内分泌科,广东省珠海市519000 [2]中山大学附属第五医院心内科,广东省珠海市519000 [3]中山大学附属第五医院神经内科,广东省珠海市519000

出　　处：《中国医药》2010年第4期323-324,共2页China Medicine

摘　　要：目的评价不同疗程胰岛素强化治疗对口服降糖药治疗失效的2型糖尿病患者胰岛β细胞功能的保护作用。方法64例口服降糖药治疗失效的2型糖尿病患者按胰岛素强化治疗疗程分成3组，10d组20例，30d组22例，60d组22例。计算胰岛素强化治疗期间胰岛素使用日最大剂量和最后一天血糖达标时剂量，计算3组β细胞功能指数和胰岛素抵抗指数。结果30d组和60d组在疗程结束时，血糖达标的胰岛素基础量和餐前量均较10d组少；60d组平均胰岛素日用量为（1．1±0．14）U／（kg·d），显著低于10d组[（1．6±0．12）U／（kg·d）]；3组糖化血红蛋白均较治疗前下降，以60d组最显著。1年后60d组有68％单用口服降糖药即可有效控制血糖。结论胰岛素强化治疗60d更有利于口服降糖药失效的2型糖尿病患者β细胞功能的改善。Objective To evaluate the effect of different courses of intensive insulin therapy on protection of pancreatic β-cell function in oral hypoglycemic agent failed type 2 diabetes （T2DM）. Methods According to courses of intensive insulin therapy, 64 patients with OHA failed T2DM were divided into group A（20 cases, 10 days）, group B （22 cases, 30 days）and group C （22 cases, 60 days）. Results At the end of different courses, the daily administration of basic dose and premeal supplementary dose of insulin at target blood glucose level in group B and C were lower than group A. The average dose of total daily insulin in group C was significantly lower than that in group A. The insulin secretion and C-peptide secretion was significantly improved in group B and C. Glycosylated hemoglobin decreased in all groups, most significantly in group C（P 〈0.05）. After 1 year, blood glucose level was effectively controlled by oral hypoglycemic agents alone in 61% cases of group B and 68% of group C. Conclusion Sixty days of intensive insulin therapy is effective to recover β-cell function in with OHA failed T2DM patients.

关 键 词：糖尿病 2型 胰岛素强化治疗 口服降糖药 胰岛Β细胞 

分 类 号：R587.1[医药卫生—内分泌]