·糖尿病的胰岛素治疗·

　　作者单位：226001江苏，南通大学附属医院内分泌科

　　餐后2小时C肽与空腹C肽比值(C2/C0)作为预测新诊断的2型糖尿病胰岛素强化治疗指标的观察

　　唐祝奇 崔世维 朱晓晖 王粹芳 印彤

　　【摘要】目的探讨100 g馒头餐2 hC-P与FC-P比值(C2/C0)在胰岛素强化治疗中的临床意义。方法新诊断的T2DM患者87例，分为Ⅰ组(C2/C0≥3，n=43)和Ⅱ组(C2/C0<3，n=44)，经2～3周的胰岛素强化治疗，随访3个月，比较两组间的降糖方案和血糖控制情况。结果Ⅰ组比Ⅱ组有更多的患者可采用单独生活方式干预控制血糖良好(20/43 vs 5/44,P<0.05);Ⅱ组比Ⅰ组有更多的患者需胰岛素控制血糖(21/44 vs 9/43，P<0.05);需用口服降糖药者两组间病例数上差异无统计学意义(14/43 vs 18/44, P>0.05)，Ⅰ组患者比Ⅱ组患者需要的口服降糖药少。结论新诊断的T2DM患者的C2/C0比值，可作为胰岛素强化治疗的预测指标，C2/C0≥3的患者胰岛素强化治疗的获益更大。

　　【关键词】糖尿病,2型;C肽; 血糖;胰岛素强化治疗

　　doi:10.3969/j.issn.1006-6187.2012.05.010

　　The C2/C0 ratio (2 h postprandial over fasting C-peptide ratio) may be a predictive index for glucose control after insulin intensive therapy in newly diagnosed type 2 diabetesTANG Zhu-qi, CUI Shi-wei，ZHU Xiao-hui, et al. Department of Endocrinology. The Affiliated Hospital of Nantong University. Jiangsu Nantong 226001, China

　　【Abstract】ObjectiveTo investigate whether the ratio of the 2 h postprandial to fasting C-peptide(C2/C0) can be a predictive index for glucose control after intensive insulin therapy in newly diagnosed type 2 diabetes. MethodsEighty-seven newly diagnosed type 2 diabetic inpatients were divided into two groups: groupⅠ(C2/C0 ratio≥3，n=43)and group Ⅱ(C2/C0 ratio<3，n=44), then treated with continuous subcutaneous insulin infusion for 2～3 weeks, followed up after 3 months. The levels of glycemia control were compared between two groups. ResultsCompared to group Ⅱ, there were more patients in group Ⅰ getting good glycemia control by life style intervention alone(20/43 vs 5/44, P<0.05). Group Ⅱ showed that more patients (21/44 vs 9/43, P<0.05) needed insulin treatment, as compared to group Ⅰ. ConclusionsThe ratio of C2/C0 can be used as a predictive index for glycemia control after short-term intensive insulin therapy in newly diagnosed type 2 diabetic patients. The patients with C2/C0≥3 can get more benefits from short-term intensive insulin therapy than those with C2/C0<3.

　　【Key words】Diabetes mellitus,type 2; C-peptide; Blood glucose; Intensive therapy.