·糖尿病的胰岛素治疗·

　　张倩 曹瑛 高方 叶潇 李际敏 薛耀明

　　作者单位：510515广州，南方医科大学南方医院内分泌代谢科

　　通讯作者：薛耀明，E-mail：yaomingxue@126.com

　　【摘要】目的对HbA1c>9%的新诊断的T2DM患者进行地特胰岛素(Det)联合二甲双胍的短期强化治疗，探讨Det作为基础胰岛素的疗效。方法40例新诊断的T2DM患者随机分为治疗组与对照组，每组20例，治疗组予以Det联合二甲双胍治疗，对照组予以格列美脲及二甲双胍治疗，疗程12周，对其在治疗前后血糖控制情况及胰岛β细胞功能进行自身及组间比较。结果治疗后两组FBG、2hBG及标准餐血糖曲线下面积(AUC-G)、HbA1c、HOMA-IR均显著下降，HOMA-β升高(P均<0.01)。Det组FBG、2hBG、AUC-G及HOMA-β治疗前后的差值高于对照组，差异有统计学意义(P<0.05)。Det组在降低血糖的同时更好地改善了基础胰岛β细胞功能。结论Det作为基础胰岛素联合二甲双胍治疗为新诊断时HbA1c>9%的T2DM患者提供了一种简便、有效、安全的门诊强化治疗方案。

　　【关键词】糖尿病，2型;Det;强化治疗;胰岛β细胞功能

　　doi:10.3969/j.issn.1006-6187.2012.03.013

　　The therapeutic effect of insulin detemir plus metformin in newly diagnosed type 2 diabetic patientsZHANG Qian, CAO Ying, GAO Fang et al.Department of Endocrinology, Nanfang Hospital, Guangzhou 510515, China

　　Corresponding author：XUE Yao-ming，E-mail：yaomingxue@126.com

　　【Abstract】ObjectiveTo evaluate the effects of combination therapy of insulin Detemir and metformin on glucose control and β-cell function in newly diagnosed type 2 diabetic patients.Methods40 newly diagnosed type 2 diabetic patients were randomly divided into treatment group and control group, 20 patients in each group. The treatment group received insulin detemir combined with metformin, and the control group received glimepiride and metformin. The therapeutic effects were measured after 12-week intensive therapy.ResultsAfter the treatment, FBG, 2hBG，area under curve of glucose(AUC-G) and HbA1c were significantly decreased (P<0.01) in each group.HOMA-β was increased and HOMA-IR was decreased (P<0.01) in each group. The differences of FBG, AUC-G and HOMA-B between before and after the treatment in insulin detemir group were higher than in the control group (P<0.05). The β-cell function was improved more significantly with the better glucose control after the treatment of insulin detemir combined with metformin.ConclusionsThe results suggest insulin detemir as basal insulin provides a convenient, effective and safe therapy for newly diagnosed type 2 diabetic patients.

　　【Key words】Diabetes mellitus，type 2; Insulin detemir; Intensive therapy; β-cell function