基于中国2型糖尿病患者的胰岛素分泌特点选择适宜的起始胰岛素治疗  

Based on insulin secretion character of Chinese type 2 diabetes patients,choose the appropriate initial insulin therapy

作　　者：孙侃[1] 

机构地区：[1]新疆石河子大学医学院第一附属医院内分泌科,832000

出　　处：《中国糖尿病杂志》2014年第8期766-767,768,共3页Chinese Journal of Diabetes

摘　　要：在T2DM发生和发展过程中,同时存在胰岛素分泌减少和IS减弱的问题。不同种族人群的胰岛素分泌和IS缺陷呈现不同特征,中国T2DM患者更突出表现为胰岛素分泌不足,且以早相分泌缺陷为主,血糖异常以餐后血糖升高为主要表现。针对中国T2DM患者的上述特点,应适时起始胰岛素治疗,并给予可同时补充基础胰岛素分泌和早相分泌缺陷的治疗。多项随机临床试验和观察性研究表明,预混胰岛素类似物门冬胰岛素30(BIAsp30)每日两次起始治疗具有很好的降糖疗效,且低血糖风险低,体重变化不明显。BIAsp30每日一次注射也可作为起始治疗的更多选择。此外,BIAsp30的治疗方案调整简单方便,在从起始到强化的胰岛素治疗全程中,皆可方便、灵活地使用。In the development and progress of type 2 diabetes （T2DM）,the defects of insulin secretion and insulin insensitivity coexit.In different ethnic population,the defects of insulin secretion and insulin sensitivity showed different characteristics.In Chinese T2DM patients,the most prominent manifestation is inadequate insulin secretion,especially the early phase secretion defects.Therefore,postprandial hyperglycemia is very common.Based on these features of Chinese T2DM patients,the rational method is to early initiate insulin therapy and use insulin formations that can cover both basal and early phase prandialinsulin secretiondefects.A variety of randomized clinical trials and observational studies have shown that twice-daily premixed insulin analogues BIAsp30 initiation treatment can achieve good hypoglycemic effect with low risk of hypoglycemia and minimal weight change.BIAsp30 once-daily injections can also be used as alternative initial therapy.The use of BIAsp30 is easy to adjust.In conclusion,from the insulin initiation to insulin intensification,BIAsp30 therapy can be used conveniently and flexibly for Chinese T2DM patients.

关 键 词：糖尿病 2型 胰岛素分泌 胰岛Β细胞功能 胰岛素敏感性 胰岛素起始治疗 预混胰岛素类似物 门冬胰岛素30 

分 类 号：R587.1[医药卫生—内分泌]