血糖谱与胰岛素分泌曲线在2型糖尿病合理选择胰岛素促泌剂中的应用  

Application of Blood Glucose Profile and Insulin Secretion Curve in Rational Selection of Insulin Secretagogues in Type 2 Diabetes

作　　者：姜君 李杰玉[2] 许勤华[1] JIANG Jun;LI Jie-yu;XU Qin-hua(Department of Emergency Internal Medicine,Nanyang Central Hospital,Nanyang,Henan,473000,China;Department of Endocrinology,Nanyang Central Hospital,Nanyang,Henan,473000,China)

机构地区：[1]南阳市中心医院急诊内科,河南南阳473000 [2]南阳市中心医院内分泌科,河南南阳473000

出　　处：《中国血液流变学杂志》2023年第2期226-230,共5页Chinese Journal of Hemorheology

摘　　要：目的探究胰岛素分泌曲线和血糖谱在2型糖尿病选择胰岛素促泌剂中的价值,为临床胰岛素促泌剂选择提供依据。方法前瞻性选取2020年8月—2022年7月南阳市中心医院住院的120例2型糖尿病患者为研究对象,采用抽签法将其分为实验组和对照组各60例,其中对照组根据患者的血糖谱选择胰岛素促泌剂,实验组根据胰岛素分泌曲线选择胰岛素促泌剂。比较两组患者治疗后血糖控制情况[空腹血糖(fasting plasma glucose,FPG)、餐后2 h血糖(2-hour postprandial plasma glucose,2h-PG)]、控制达标情况(达标平均天数、血糖控制达标率)、胰岛素抵抗指标、低血糖发生率和住院天数。结果两组患者治疗前FPG、2h-PG差异无统计学意义(P>0.05),治疗后两组水平均明显下降(P<0.05),且实验组较对照组更低(P<0.05)。相较于对照组,实验组达标平均天数更多(P<0.05),出院时血糖控制达标率更高(P<0.05),治疗后HOMA-IR更高(P<0.05),住院天数更少(P<0.05),低血糖发生率更低,但是差异无统计学意义(P>0.05)。结论相较于血糖谱,胰岛素分泌曲线可以更好地明确不同胰岛β细胞功能的2型糖尿病患者如何选择不同类型的胰岛素促泌剂,从而安全有效地控制血糖。Objective To explore the value of insulin secretion curve and blood glucose profile in the selection of insulin secretagogues in type 2 diabetes,and to provide a basis for clinical selection of insulin secretagogues.Methods 120 patients with type 2 diabetes hospitalized in Nanyang Central Hospital from August 2020 to July 2022 were prospectively selected as the research objects.They were divided into an experimental group and a control group with 60 patients each by lot drawing.The control group selected insulin secretagogues according to the patients'blood glucose profile,and the experimental group selected insulin secretagogues according to the insulin secretion curve.After treatment,the blood glucose control[fasting plasma glucose(FPG),2-hour postprandial plasma glucose(2h-PG)],control compliance(average days of compliance,rate of compliance with blood glucose control),insulin resistance indicators,incidence of hypoglycemia,and hospital stay were compared between the two groups.Results There was no statistical difference between FPG and 2h-PG in the two groups before treatment(P>0.05).After treatment,the levels of FPG and 2h-PG in the two groups decreased significantly(P<0.05),and the experimental group was lower than the control group(P<0.05).Compared with the control group,the experimental group had more average days of reaching the standard(P<0.05),higher rate of reaching the standard of blood glucose control at discharge(P<0.05),higher HOMA-IR after treatment(P<0.05),fewer days in hospital(P<0.05),and lower incidence of hypoglycemia,but the difference was not statistically significant(P>0.05).Conclusion Compared with blood glucose profile,insulin secretion curve can better identify different isletsβhow to choose different types of insulin secretagogues for type 2 diabetes patients with cell function,so as to control blood sugar safely and effectively.

关 键 词：血糖谱 胰岛素分泌曲线 2型糖尿病 胰岛素促泌剂 血糖控制 

分 类 号：R587.1[医药卫生—内分泌]