LADA老年患者治疗中胰岛素强化方法对胰岛β细胞功能和临床疗效的影响  

作　　者：陈宇[1] 马丽珍[1] 沈俊娅[1] 詹宇红[1] 

机构地区：[1]杭州市第一人民医院内分泌科,310006

出　　处：《浙江临床医学》2017年第8期1436-1437,1440,共3页Zhejiang Clinical Medical Journal

摘　　要：目的 对比老年2型糖尿病（DM）患者及老年成人隐匿性自身免疫性糖尿病（LADA）患者进行胰岛素强化方法 治疗的胰岛β细胞功能和治疗效果.方法选取2011年2月至2015年6月就诊的共44例2型DM患者作为DM组.选取同期的46例LADA患者作为LADA组.采用胰岛素强化治疗,对比两组患者治疗前后胰岛β细胞功能,治疗前后空腹及餐后1h和2h的C肽、胰岛素、糖化血红蛋白（HbA1c）、血糖水平.结果 DM组患者治疗前后HOMA-IS显著高于LADA组患者,且差异均有统计学意义（P〈0.05）,两组患者治疗后HOMA-IS水平明显高于各组治疗前,且差异具有统计学意义（P〈0.05）.DM组患者治疗前后的空腹、餐后1h和餐后2hC肽和胰岛素水平均明显高于LADA组患者,且差异均有统计学意义（P〈0.05）,两组患者治疗后空腹、餐后1h和餐后2hC肽和胰岛素水平均明显高于治疗前,且差异均有统计学意义（P〈0.05）.两组患者治疗前后HbA1c、空腹血糖和2h血糖水平对比均无明显差异（P〉0.05）,两组患者治疗后HbA1c、空腹血糖和2h血糖水平均明显低于治疗前,且差异均有统计学意义（P〈0.05）.结论 应用胰岛素强化方法治疗老年LADA患者在临床疗效方面明显优于2型DM患者.Objective To compare the β-cell function and clinical efficacy of intensive insulin therapy of elderly patients with type 2 DM and LADA. Methods 44 type 2 DM patients of our hospital between February 2011 and June 2015 were selected as DM group,while 46 LADA patients contemporaneous as LADA group . Intensive insulin therapy were applied to all patients,the β-cell function pre-treatment and post-treatment, fasting,1 hour postprandial and 2 hours postprandial C-peptide,insulin,HbA1c,glucose pre-treatment and post-treatment were compared . Results The HOMA-IS level of DM group pre-treatment and post-treatment were all much higher than LADA group（P〈0.05）. The post-treatment HOMA-IS level of two groups were both much higher than pre-treatment（P〈0.05）. The pre-treatment and post-treatment fasting,1 hour postprandial and 2 hours postprandial C-peptide,insulin level of DM group were much higher than LADA group（P〈0.05）. The post-treatment fasting,1 hour postprandial and 2 hours postprandial C-peptide,insulin level were much higher than pre-treatment（P〈0.05）. The pre-treatment and post-treatment HbA1c,fasting glucose and 2 hours postprandial of two groups had no statistical difference（P〉0.05）. The post-treatment HbA1c,fasting glucose and 2 hours postprandial of two groups were much less than pre-treatment（P〈0.05）. Conclusion The effect of insulin intensive therapy on elderly patients with LADA is significantly better than that of patients with type 2 DM .

关 键 词：成人隐匿性自身免疫性糖尿病 胰岛素强化方法 胰岛素β细胞功能 

分 类 号：R587.1[医药卫生—内分泌]