诺和锐30强化治疗对初诊2型糖尿病患者第一时相胰岛素分泌的影响  

Effects of intensive insulin therapy by BIAsp30 on insulin first- phase secretion in newly diagnosed type 2 diabetic patients

作　　者：杨洁[1] 唐暎[1] 华飞[1] 戈敏娟[1] 刘震宇[1] 蒋晓红[1] 胡文来[1] 

机构地区：[1]常州市第一人民医院内分泌科,江苏213003

出　　处：《常州实用医学》2011年第3期161-164,共4页CHANGZHOU PRACTICAL MEDICINE

摘　　要：目的探讨短期诺和锐30强化治疗对初诊2型糖尿病患者第一时相胰岛素分泌缺陷的作用。方法对30例初诊2型糖尿病患者进行每日3次诺和锐30强化治疗2周，治疗前后分别行IVCTT试验，测定0、3、4、5、8、10、120分钟血糖、胰岛素及C肽值，评估胰岛素第一时相分泌情况，并计算治疗前后胰岛素和C肽曲线下面积（AUC）及稳态模式评估法胰岛素抵抗指数（HOMA—IR）。结果在诺和锐30强化治疗后，患者血清胰岛素及C肽在3,4、5、8、10分钟的分泌均明显增加，治疗前后胰岛素AUC0-10min。分别为64．70±28．18mIU×min／L和98．2±32．57mIU×min／L（P〈0．01），C肽AUC0-10min分别为14．75±4．91μg×min／L和21．28±6．12μg×min／L（P〈0．01）.HOMA—IR指数明显降低，治疗前后分别为2．86±1．19和1．69±0．61（P〈0．01）。结论对于初诊2型糖尿病患者，每日3次诺和锐30强化治疗能明显改善胰岛素第一时相分泌，一定程度地改善p细胞功能及胰岛素抵抗，因此可能带来长期有益的效果。Objective To explore the effects of transient intensive therapy with BIAsp30 on first- phase insulin secretion in newly diagnosed type 2 diabetic patients. Methods Thirty newly diagnosed T2DM patients were treated with thrice daffy BI Asp30 intensive therapy for 2 weeks.Intravenous glucose tolerance tasts（IVGTT） were performed before and after the treat- ments.During IVGTT,level of blood glucase,insulin and C-peptide of 0,3,4,5,8,10,120 minutes after glucose injection were measured.AUC of insulin and C- peptide and HOMA- Ht indexes were calculated. Results After two weeks＇ intensive treatment,level of insulin and C - peptide increased significantly except for 0 min and 120 rain. Compared to the baseline,AUC 0 - 10 rain of insulin was increased from 64.70±28.18 mIU×min/L to 98.2± 32.57 mIU×min/L（P 〈 0.01）and C- peptide was in- creased from 14.75 ± 4.91μg×min/Lto 21.28 ± 6.12 μg×min/L（ P 〈 0.01 ）. Furthermore, HOMA - IR index was decreased from 2.86± 1.19 to 1.69 ± 0.61（ P 〈 0.01）. Conclusion Thrice daily BIAsp30 intensive therapy may significantly improve the first- phase insulin secretion in newly diagnosed T2DM patients and lead to long- term beneficial effects.

关 键 词：第一时相胰岛素分泌 初诊2型糖尿病 诺和锐30 强化治疗 患者 胰岛素第一时相分泌 胰岛素抵抗指数 稳态模式评估法 

分 类 号：R58[医药卫生—内分泌]