短期胰岛素强化治疗对超重初诊2型糖尿病胰岛素抵抗的干预  

Interventional effect of short-term continuous subcutaneous insulin infusion(CSⅡ) therapy on insulin resistance in overweight patients with newly-diagnosed type 2 diabetes

作　　者：蒋小红[1] 黄珊[1] 彭文芳[1] 

机构地区：[1]上海市长宁区中心医院内分泌科,上海200336

出　　处：《实用临床医药杂志》2012年第15期38-40,共3页Journal of Clinical Medicine in Practice

基　　金：中国高校医学期刊临床专项资金(11220082)

摘　　要：目的探究非严重高血糖的超重初诊2型糖尿病患者采取短期胰岛素泵强化治疗能否获益,以及探讨强化治疗后的降糖方案。方法 120例超重(24≤BMI<28 kg/m2)初诊2型糖尿病患者随机分为3组,各40例:胰岛素泵+二甲双胍组(A组);胰岛素泵+预混入胰岛素组(B组);二甲双胍组(C组)。分别在治疗前、治疗2周及12周,测定糖化血红蛋白(HbA1c),口服75 g葡萄糖耐量(OGTT)空腹及2 h血糖(FBG、2 hPBG)、胰岛素(FINS、2hINS)、C肽(FCP、2 hCP),计算胰岛β细胞功能指数(HOMAβ)和胰岛素抵抗指数(HOMA IR)。结果治疗前3组间无统计学差异;治疗2周时A、B组FBG、2 hPBG、HbA1c、2 hINS、HOMA IR低于C组;治疗12周时A、B组2 hPBG、HbA1c低于C组;A组FINS、FCP、OGTT 2 hINS、HOMA IR低于B、C组;B组BMI高于A、C组,HOMAβ高于A组。结论短期胰岛素泵强化治疗有益于改善非严重高血糖超重初诊2型糖尿病患者的胰岛素抵抗,而强化治疗后二甲双胍续贯治疗更显优势。Objective To investigate the effect of short-term continuous subcutaneous insulin infusion（CSⅡ） on overweight patients with newly-diagnosed type 2 diabetes whose plasma glucose isn′t very high and explore a treatment program to decrease plasma glucose after CSII.Methods A total of 120 overweight patients with newly-diagnosed type 2 diabetes were randomized into three groups with 40 cases in each： group A（CSⅡ followed by oral metformin group）,group B（CSⅡ followed by nouvolin30R group）,and group C（metformin group）.The levels of HbA1c,fasting plasma glucose（FBG）,insulin（FINS） and C-peptide（FCP）,75 g glucose OGTT 2 hours glucose（2hPBG）,insulin（2hINS）,C-peptide（2hCP）,insulin secretion index（HOMAβ） and insulin resistance index（HOMA IR） were compared before,2 weeks and 12 weeks after treatment.Results Before treatment,there were no differences in all items observed among three groups.Two weeks after treatment,FBG,2hPBG,HbA1c,2hINS and HOMA IR were lower in groups A and B than in group C.Twelve weeks after treatment,HbA1c and 2hPBG were lower in groups A an B than in group C.FINS,FCP,OGTT,2hINS and HOMA IR were lower in group A than in groups B and C.Conclusion Short-term CSⅡ can effectively improve the insulin sensitivity in overweight patients with newly-diagnosed type 2 diabetes whose plasma glucose isn’t very high.These patients may get most benefits from short-term CSⅡ followed by oral metformin treatment.

关 键 词：2型糖尿病 超重 初诊 胰岛素强化治疗 

分 类 号：R581.1[医药卫生—内分泌]