·糖尿病胰岛素治疗·

　　【摘要】 目的 观察口服降糖药物治疗5～10年的T2DM患者改用胰岛素治疗，能否改善胰岛β细胞功能。 方法 口服降糖药物治疗5～10年的T2DM患者128例，随机等分成治疗组和对照(NC)组，各64例。治疗组采用三餐前门冬胰岛素联合睡前甘精胰岛素治疗，NC组继续口服降糖药物治疗，比较血糖控制达标的时间和治疗前后C-P水平的变化。 结果 两组年龄、性别、糖尿病病程、HbA1c、治疗前BMI、基础及糖负荷后1 h、2 h、3 hC-P比较差异均无统计学意义;治疗组血糖控制达标所需时间，较NC组缩短，差异有统计学意义(P<0.01);治疗组治疗后空腹、糖负荷后1 h、2 h、3 hC-P值，较自身治疗前及NC组均增加，差异有统计学意义(P<0.01)。 结论 口服降糖药物治疗5～10年的T2DM患者，胰岛素治疗可改善胰岛β细胞功能。

　　【关键词】 糖尿病，2型;胰岛素治疗;口服降糖药物;胰岛β细胞功能

Effect of short-term mealtime insulin aspart and bedtime insulin glargine treatment on C-peptide secretion in T2DM patients treated with oral antidiabetic agents for 5-10 years DING Li-xin, HE Wei-li, KANG Ju-ge, et al. Department of Endocrinology, Chang’an Hospital, Xi’an 710016, China

　　【Abstract】Objective To observe whether insulin therapy could improve islet β cell functions in T2DM patients treated with oral antidiabetic agents (OAA) for 5～10 years. Methods The 128 T2DM patients treated with OAA for 5～10 years were randomized into treatment and control groups, with 64 cases in each. The treatment group was prescribed with insulin aspart for subcutaneous injection prior to each meal and insulin glargine at bedtime, while the control group continued to receive OAA therapy. The time for well-controlled glucose levels and basal and 1 h, 2 h, 3 h postchallenge serum C-P levels were compared between the two groups. Results There was no statistically significant difference in age, gender, BMI, course of disease, HbA1c, and basal and 1 h,2 h,3 h postprandial serum C-P levels before treatment between the two groups. The treatment group achieved more rapidly good glycemic control than the control group (P<0.01). Basal and 1 h,2 h,3 h postprandial serum C-P levels after treatment were higher than those before treatment in the treatment group (P<0.01), and higher than those after treatment in the control group (P<0.01). Conclusion Insulin therapy could improve islet β cell functions in T2DM patients treated with OAA for 5～10 years.

　　【Key words】 Diabetes mellitus, type 2; Insulin therapy; Oral antidiabetic agents; Islet β cell functions