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短期胰岛素强化治疗对新诊断2型糖尿病相关指标的影响

来自:中国糖尿病资讯网  编辑:editor|点击数:|2013-02-21

  【摘要】 目的 探讨短期胰岛素强化治疗对新诊断T2DM患者相关指标的影响。 方法 采用多次皮下注射(MSII)和胰岛素泵持续皮下输注(CSII)方案对64例新诊断T2DM 患者进行短期强化治疗,比较治疗前后FPG、2 hPG、TC、TG、 LDL-C、HDL-C、FFA、C-RP、精氨酸刺激试验、胰岛素分泌指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)的变化。 结果 两组患者治疗达标后FPG、2 hPG、TC、TG、LDL-C、FFA、C-RP、HOMA-IR均显著下降(P<0.05),HOMA-β、快速胰岛素分泌值(Ins2+4+6)显著增高(P<0.05),而两组间无明显差异(P>0.05);Pearson相关分析显示,HOMA-β、Ins2+4+6的升高与FPG、FFA下降正相关(P<0.05),多元逐步回归分析显示BMI是影响HOMA-β、Ins2+4+6的独立相关因素(P=0.000)。 结论 短期胰岛素强化治疗可明显改善新诊断T2DM患者的胰岛β细胞功能,减轻IR,β细胞功能的改善与糖代谢、脂代谢的改善以及体重密切相关。

  【关键词】 糖尿病,2型; 胰岛素强化治疗; 精氨酸刺激试验; 胰岛β细胞功能

  Effects of transient intensive insulin treatment on the related indices of newly diagnosed T2DM patients ZHAI Ying-jiu, ZHOU Li-nuo, FANG Ming-xi, et al. Department of Endocrinology, Zhoupu Hospital, Shanghai 201318,China

  Corresponding author: ZHOU Li-nuo, E-mail: nally_zhou@yahoo.com.cn

  【Abstract】 Objective To study the effect of transient intensive insulin treatment on the related indices of newly diagnosed T2DM patients. Methods Sixty-four newly diagnosed T2DM patients were divided into two groups and treated by transient intensive insulin treatment in the way of multiple subcutaneous insulin infusion (MSII) and continuous subcutaneous insulin infusion (CSII). The fasting plasma glucose (FPG), 2 hours postprandial glucose (2 hPG), serum total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), free fatty acid (FFA), C-reactive protein(C-RP), argentine stimulation test (Ins 0, 2, 4, 6 minute), HOMA-β, and HOMA-IR were determined before and after treatment for comparison. Results After treatment in both groups the levels of FPG,2 hPG, TC, TG, LDL-C, FFA, CRP, and HOMA-IR were decreased significantly (P<0.05), and the levels of HOMA-βand Ins2+4+6 were increased significantly(P<0.05). There was no significant difference between the two groups (P>0.05). Pearson correlation analysis showed that the increase of HOMA-β and Ins2+4+6 was positively correlated with the decrease of FPG and FFA (P<0.05). The multiple regression analysis showed that BMI was an independent related factor affecting HOMA-βand Ins2+4+6 (P=0.000). Conclusion The transient intensive insulin treatment can evidently improve beta-cell functions and relieve insulin resistance in newly diagnosed T2DM patients. The improvement of islet β-cell function is related to the improvement of glucose metabolism, lipid metabolism, and bodyweight.

  【Key words】Diabetes mellitus, type 2; Insulin intensive treatment; Argentine stimulation test; Islet β-cell function

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