口服药及胰岛素治疗对初发2型糖尿病患者β细胞功能影响的比较  

Comparison of different effects of oral hypoglycemic agents and insulin therapy on β-cell function in patients with newly diagnosed Type 2 Diabetes

作　　者：邓敏[1] 

机构地区：[1]天津电力医院内科,300171

出　　处：《中国误诊学杂志》2011年第7期1521-1523,共3页Chinese Journal of Misdiagnostics

摘　　要：目的观察口服药及胰岛素治疗对初发2型糖尿病患者β细胞功能的不同影响。方法 68例初诊2型糖尿病患者在饮食及运动干预下,随机分为胰岛素组(Ins)33例及口服药组(OHA)35例,观察两组治疗前后FPG、2hPG、HbA1c、C-p、Ins等相关指标。用胰岛素抵抗指数(HOMA-IR)评价胰岛素敏感性,用胰岛β细胞功能指数(HOMA-β)评价β细胞功能,用胰岛素初期分泌功能指数(△I30/△G30)评价糖负荷早期β细胞的分泌功能,并计算胰岛素曲线下面积(AUGIns)。结果 (1)随防至12个月时,Ins组和OHA组的HOMA-β、△I30/△G30、AUGIns均较治疗前明显升高,但Ins组效果优于OHA组,与OHA组比较差异有统计学意义(P<0.01);(2)HOMA-β、△I30/△G30及AUGIns水平均较治疗前显著升高(P<0.01),Ins组较OHA组升高更显著,差异有统计学意义(P<0.01)。结论对初发2型糖尿病患者选择胰岛素治疗可以更好地保护胰岛β细胞功能,而且这种保护可以产生长期的影响。Objective To observe the different effects of oral hypoglycemic agents and insulin therapy on β-cell function in patients with newly diagnosed Type 2 Diabetes（T2DM）.Methods 68 newly diagnosed Type 2 diabetes patients,paralleled with the treatment of diet and physical exercise,were assigned to therapy with insulin（Ins,33） or oral hypoglycaemic agents（OHA,35） randomly.Related parameters,including：FPG、2hPG、HbA1c、C-p and Ins,were observed before and after the treatment.The insulin sensitivity was evaluated by HOMA-IR.The β-cell function was evaluated by HOMA-β.And the early phage secretion function of β-cell was evaluated with △I30/△G30,and AUGInswas calculated.Results（1） After 12 months follow-up,the levels of HOMA-β、△I30/△G30and AUGInswere significantly elevated in these two groups.And the insulin group group was superior to OHA group.There were significant differences of the change of these characteristics between the two group（P0.01）;（2）After 60-months follow-up,the levels of HOMA-β、△I30/△G30and AUGInswere significantly elevated in these two groups.And the insulin group group was superior to OHA group.There were significant differences of the change of these characteristics between the two group（P0.01）.Conclusions Early insulin therapy in patients with newly diagnosed type 2 diabetes has better effect on protection of beta cell function compared with treatment with oral hypoglycaemic agents.And this effect has long duration favourable outcomes.

关 键 词：胰岛素/治疗应用 糖尿病 2型/药物疗法 胰岛/生理学 

分 类 号：R587.1[医药卫生—内分泌]