初诊T2DM患者短期胰岛素泵强化治疗后后续治疗方案选择  

Selection of follow-up treatment options after short-term intensive insulin pump therapy in newly diagnosed T2DM patients

作　　者：田雪品[1] 翟铁[1] 郝凤杰[1] 刘海英[1] 

机构地区：[1]承德市中心医院,河北承德067000

出　　处：《山东医药》2017年第28期25-27,共3页Shandong Medical Journal

基　　金：河北省医学科学研究重点课题计划(20160307)

摘　　要：目的探讨初诊2型糖尿病(T2DM)患者短期胰岛素泵强化治疗后最佳后续治疗方案。方法选择经短期胰岛素泵强化治疗后血糖控制达标的初诊T2DM患者84例,随机分为观察组、对照组各42例。对照组后续给予口服降糖药治疗,观察组后续给予基础胰岛素皮下注射治疗。分别于治疗前和随访2年时,检测两组空腹血糖(FPG)、糖化血红蛋白(Hb A1c)及空腹C肽(FCP),计算BMI及胰岛素分泌指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR);同日检测颈动脉内膜-中膜厚度(IMT),计算颈动脉斑块检出率。结果两组治疗后Hb A1c、BMI均低于治疗前(P均<0.05),但两组治疗后比较差异无统计学意义(P均>0.05)。两组治疗后HOMA-IR均低于治疗前,HOMA-β均高于治疗前,且以观察组治疗后变化更明显(P均<0.05)。对照组治疗后颈动脉IMT高于治疗前(P<0.05),但观察组治疗前后比较差异无统计学意义(P>0.05),观察组治疗后颈动脉IMT低于对照组治疗后(P<0.05)。两组治疗前后颈动脉斑块检出率比较差异均无统计学意义(P均>0.05)。结论初诊T2DM患者短期胰岛素泵强化治疗后皮下注射胰岛素后续治疗对改善胰岛功能的效果优于口服降糖药后续治疗。Objective To explore the optimal subsequent therapeutic regimen for newly diagnosed patients with type 2diabetes mellitus（ T2DM） after short-term intensive insulin therapy with insulin pump. Methods Eighty-four newly diagnosed T2 DM patients with up-to-standard blood glucose after short-term intensive insulin therapy with insulin pump were selected. They were randomly divided into the observation group and control group,with 42 cases in each group. Patients in the control group were administered oral hypoglycemic agents for subsequent treatment,while patients in the observation group received subcutaneous injection of basal insulin for subsequent treatment. The fasting blood glucose（ FBG）,glycosylated hemoglobin（ Hb A1c） and fasting C peptide（ FCP） were detected before treatment and after 2-year follow-up. Moreover,the BMI,insulin secretion index（ HOAM-β） and insulin resistance index（ HOAM-IR） were calculated. Meanwhile,the carotid intima-media thickness（ IMT） was detected on the same day,and the carotid plaque detection rate was also calculated. Results Hb A1 c and BMI in both groups after treatment were lower than those before treatment（ all P〈0. 05）,but the differences after treatment between these two groups were not statistically significant（ all P〈0. 05）. HOMA-IR in both groups after treatment was lower than that before treatment,while HOAM-β was higher than that before treatment,and the changes in the observation group were more significant（ all P〈0. 05）. Carotid IMT in the control group after treatment was higher than that before treatment（ P〈0. 05）,but the difference in the observation group before and after treatment was not statistically significant（ P〈0. 05）. In addition,carotid IMT in the observation group after treatment was lower than that in the control group after treatment（ P〈0. 05）. Differences in carotid plaque detection rate between two groups before and after treatment were not statistically significant（ all P〈0. 05）. Co

关 键 词：2型糖尿病 胰岛素泵强化治疗 后续治疗 血糖 胰岛功能 颈动脉内膜-中膜厚度 

分 类 号：R587.1[医药卫生—内分泌]