【关键词】糖尿病，2型；持续皮下胰岛素输注；尿白蛋白/肌酐；血糖波动

A retrospective study on the risk of long-term albuminuria in newly diagnosed type 2 diabetic patients after continuous subcutaneous insulin infusion therapy   HE Rui-ting,  LÜ Xiao-feng,  WU Jin-xiao，et al. Department of Endocrinology, The Second Affiliated Hospital of Shanxi Medical University，Taiyuan 030001，China

【Abstract】  Objective  To investigate the effect of early continuous subcutaneous insulin infusion (CSII) therapy on the risk of long-term albuminuria in newly diagnosed type 2 diabetic patients.  Methods  A total of 583 newly diagnosed T2DM patients hospitalized in the department of endocrinology of Beijing general military hospital from January 2000 to January 2008 were selected and divided into two groups according to their treatment during hospitalization: continuous subcutaneous insulin infusion treatment group (CSII group, n=275) and oral hypoglycemic agents treatment group (OHA group, n=308). All patients were followed up from January 2014 to June 2015 to re-evaluate their disease status and relevant indicators for the complications. Albuminuria incidence and urinary albumin/ creatinine ratio (UAlb/Cr) were compared between two groups. Sixty patients from each group were selected by stratified sampling methods according to UAlb/Cr level to take continuous glucose monitoring system (CGMS). Indicators for blood glucose fluctuation were compared between two groups and correlation between UAlb/Cr and blood glucose fluctuation was investigated.  Results  There were no significant differences in BMI，BP，HbA₁c，TG，TC and LDL-C between two groups at the follow-up visit (P>0.05). UAlb/Cr level and the incidences of 30~299 mg/24 h and ≥300 mg/24 h were lower in CSII group than in OHA group (P<0.05). The levels of mean amplitude of glycemic excursions (MAGE), standard deviation of blood glucose (SDBG), mean postprandial glucose excursion (MPPGE) and largest amplitude of glycemic excursion (LAGE) were also significantly lower in CSII group than in OHA group (P<0.05). Pearson correlation analysis showed that UAlb/Cr level was positively correlated with MAGE, SDBG, MPPGE and LAGE (r=0.227, 0.103, 0.326, 0.156，P<0.05). Multiple stepwise regression analysis showed that Course，SBP，TG and MAGE were independent risk factors for UAlb/Cr level.  Conclusion  Early continuous subcutaneous insulin infusion (CSII) therapy can lower the risk of long-term albuminuria in newly diagnosed type 2 diabetic patients, in which blood glucose fluctuation possibly works.

【Key words】Diabetes mellitus, type 2；Continuous subcutaneous insulin infusion (CSII)；Urinary albumin/ creatinine ratio（UAlb/Cr）；Blood gllucose fluctuation