【摘要】  T2DM是一种进展性疾病，患者胰岛β细胞功能的不断下降导致血糖逐渐恶化，而改善胰岛β细胞功能的干预措施则可延缓高血糖进展。胰岛素强化治疗能更好地保护胰岛β细胞功能、改善血糖控制，因此，在T2DM病程的各个阶段对患者进行胰岛素强化治疗均具有显著的临床获益。在实现胰岛素强化治疗过程中，餐后血糖(PPG)的管理尤为重要，基础-餐时胰岛素方案精细灵活，可以满足患者不断进展的治疗需求。胰岛素类似物能更好地模拟生理性胰岛素分泌，以门冬胰岛素为代表的速效胰岛素类似物和基础胰岛素联合使用或应用于持续皮下胰岛素输注（CSII）中，其作为强化治疗方案的有效性和安全性已得到一系列研究证据的支持。

【关键词】糖尿病，2型；胰岛素强化治疗；胰岛素类似物

Relationship of Type 2 diabetes mellitus progression and intensive insulin therapy

LI Yan-bin.  Department of Endocrinology, The First Affiliated Hospital,Sun Yat-sen University,Guangzhou 510080,China

【Summary】Type 2  diabetes mellitus(T2DM) is a progressive disease. Declining islet β cell function leads to the worsening of hyperglycaemia. Therefore, interventions to protect β cell function will slow down the progression of hyperglycaemia. Intensive insulin therapy can effectively control the blood glucose at all stages of T2DM. During the course of intensive insulin therapy, it is particularly important for T2DM patients to control postprandial blood glucose (PPG). Basal-bolus insulin regimen, which is accurate and flexible, taking into account both fasting glucose and PPG, can meet different demands during treatments. The efficacy and safety of short-acting insulin analogues such as insulin aspart, used in combination with basal insulin or in continuous subcutaneous insulin infusion (CSII) regimen to mimic human insulin secretion are well documented.