·糖尿病临床研究·

　　【摘要】目的 观察短期胰岛素泵强化治疗对不同病程2型糖尿病T2DM患者胰岛功能的改善的差异。方法 选择不同病程2型糖尿病T2DM患者72例，胰岛素泵强化治疗2周。治疗前后行口服葡萄糖耐量试验OGTT检测血糖及胰岛素、C-P并计算胰岛β细胞功能指数(HOMA- β))，胰岛素抵抗指数 (HOMA-IR)胰岛素抵抗指数(HOMA-IR)及胰岛素早期分泌功能指数(ΔI30/ΔG30)。结果 强化治疗前后各组HOMA-IRHoma-IR 指数差异均有统计学意义(P<0.05)。新诊断T2DM2型糖尿病组和病程1-～5年T2DM2型糖尿病组治疗前后HOMA- β胰岛功能指数Homaβ 及△I30/△G3O较治疗前升高，差异有统计学意义(P<0.05)。病程5-～10年T2DM组HOMA- β胰岛素功能指数较治疗前升高，但差异无统计学意义。结论 病程较短的T2DM2 型糖尿病患者早期使用胰岛素泵强化治疗可改善胰岛功能，包括分泌功能和IR。对于病程长的患者，强化治疗虽不能改善胰岛分泌功能，但理想的血糖控制仍能使IR减轻。

　　【关键词】糖尿病，2型;胰岛素泵;胰岛功能;胰岛素抵抗

　　Effect of short-term intensive treatment with insulin pump on beta cell function in patients with different courses of diabetes XU Ning, Ying YIN Dong, Hui HUI Yuan, et al. Department of Endocrinology, The First People’s Hospital of Lianyungang, Lianyungang 222000, China

　　【Abstract】Objective To evaluate the effect of insulin pump on pancreatic β-cells function in T2DM patients in different stages of diabetes. Methods Seventy-two T2DM patients in different stages were treated with 2-week continuous subcutaneous insulin infusion (CSII). Oral glucose tolerance tests (OGTT) were performed, and blood glucose, HbA1c, insulin, and C-peptide were measured before and after CSII. Insulin secretion index (HomaOMA- β), insulin resistance index (HOMA-IR), and early-stage insulin secretion index (ΔI30/ΔG30) were calculated before and after treatment. Results After treatment, the differences in HOMA-IR in all groups were statistically significant (P<0.05); HOMA- β and胰岛功能指数Homaβ △I30/△G3O were increased significantly in the newly diagnosed T2DM group and the 1-～5 year T2DM group (P<0.05); and HOMA- β was increased in the 5-～10 year T2DM group, but without statistical significance. Conclusion Short term intensive treatment with insulin pump can improve beta-cell function (including insulin secretion and insulin resistance) in T2DM patients in the early stage of disease. For those who are with a longer course of diabetes, although the intensive treatment is not able to improve their insulin secretion, the insulin resistance can be alleviated through the optimal glycemic control.

　　【Key words】diabetesDiabetes mellitus, type 2; insulin Insulin pump; pancreatic Pancreatic function; insulin Insulin resistance