糖尿病临床研究·

　　徐朝阳 戈越红 李慧 鲁建宏 茅国芳 许力

　　作者单位：215228江苏吴江，江苏盛泽医院内分泌科

　　【摘要】 目的 探讨短期(3个月)重组甘精胰岛素+三餐阿卡波糖强化治疗对新诊断的T2DM患者胰岛β细胞功能及血糖控制的影响。 方法 采用自身前后对照的方法，对60例新诊断但未治疗的T2DM患者给予3个月重组甘精胰岛素+阿卡波糖强化治疗，治疗前后分别行静脉葡萄糖耐量试验(IVGTT)，计算0～10min时胰岛素曲线下面积(AUC0～10)、1～3min急性胰岛素对葡萄糖的分泌反应(AIR1～3)、胰岛素分泌指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)的变化。 结果 治疗后IVGTT试验的AUC0～10、AIR1～3及HOMA-β较试验前明显增加，而空腹及餐后血糖、HbA1c、HOMA-IR较治疗前明显下降。 结论 新诊断的T2DM患者接受短期甘精胰岛素+阿卡波糖治疗使血糖快速、安全达标的同时显著改善胰岛β细胞功能和胰岛素敏感性，治疗简便，依从性较高。

　　【关键词】糖尿病，2型;静脉糖耐量试验;重组甘精胰岛素;阿卡波糖

　　doi:10.3969/j.issn.1006-6187.2011.11.016

　　The self-control study of the therapeutic effects of combined glargine insulin plus acarbose in improving the β-cell function of the newly diagnosed type 2 diabetes effectsXU Chao-yang, GE Yue-hong, LI Hui, et al. Department of Endocrinology, Nanjing Medical University First Affiliated Hospital branched Shengze Hospital, Jiangsu, Wujiang 215228, China

　　【Abstract】 Objective To investigate the treatment effects of combined glargine insulin plus acarbose in improving the β-cell function of the newly diagnosed T2DM. Methods Self-control study was used to evaluate the therapeutic effect of combined glargine insulin plus acarbose in 60 newly diagnosed T2DM patients. Intravenous glucose tolerance test (IVGTT) was performed before and after intensive therapy respectively. And the area under the concentration of insulin response curve (AUC) in the first 10mins (AUC0-10), acute insulin secresion reaction to the glucose in the first 3 mins (AIR1-3), as well as HOMA-β and HOMA-IR were calculated from IVGTT. Results The values of AUC0-10,AIR1-3 and HOMA-β after the intensive therapy were increased obviousely when compared with the values before treatment. On the other hand, the fasting and prandial blood glucose, HbA1c and HOMA-IR were decreased notably when compared with the pretreatment (P<0.05). Conclusions The treatment of combined glargine insulin plus acarbose is an effective, convenient and safe antidiabetic therapy. Moreover, the function of β cell is improved and the resistance of β cell is relieved through the therapy.

　　【Key words】 Diabetes mellitus,type 2; IVGTT; Glargine insulin; Acarbose