【摘要】 目的　观察胰岛素短期强化治疗对初诊 2型糖尿病患者胰岛β细胞功能的改善作用及降糖效果。方法对 2 4例初诊 2型糖尿病患者应用胰岛素泵进行 2周的胰岛素强化治疗 ,治疗第 15天时对比治疗前后静脉葡萄糖耐量试验所诱发的胰岛素第 1时相的分泌、胰岛素曲线下面积及由 Homa模型计算胰岛素分泌指数 (Homa B)、胰岛素抵抗指数 (Homa A) ,同时观察空腹血糖、餐后 2小时血糖变化 ;3个月时对比糖化血红蛋白变化。结果　患者空腹血糖及餐后 2小时血糖分别在治疗 (3.7± 1.8)天、 (5 .5± 1.7)天达到控制标准 ,胰岛 β细胞功能显著改善 ,静脉葡萄糖耐量试验各时点的胰岛素分泌及 Homa B值较治疗前明显升高 (P<0 .0 5 ) ,Hom a A指数下降(P<0 .0 5 )。随访 3个月 ,13例患者单纯控制饮食即可维持血糖控制标准 ,糖化血红蛋白由治疗前的 (9.8± 1.2 ) %降至 (6 .3± 0 .7) %。结论　胰岛素短期强化治疗可明显改善及恢复初诊 2型糖尿病患者胰岛素第 1时相分泌 ,不同程度的缓解病情更多还原

【Abstract】 Objective To explore the effects of short-term continuous subcutaneous insulin infusion(CSII)treatment on β-cell function and glycemic control in newly diagnosed type 2 diabetic patients.Methods Twenty four newly diagnosed type 2 diabetic patients were treated with CSII for 2 weeks,their β-cell funtion,fasting plasma glucose(FPG),2 huors postprandial glucose(2hPG),glycosylated hemoglobin A1c(GHb A 1c),the first-phase insulin secretion by intravenous glucose tolerance test(IVGTT),the mean area under the curve of insulin,Homa B and Homa A IR were assessed and compared before and after CSII.Results The rapid and safty control of FPG and 2hPG were achieved stably in(3.7±1.8)days and(5.5±1.7)days by two weeks CSII,β-cell funtion was dramatically improved,the first-phase insulin secretion of IVGTT and Homa β were significantly incresed(P<0.05),while Hom A IR were decreased(P<0.05).All pitients were followed up for 3 months after CSII,13 of them with mean GHbA 1C from(9.8±1.2)to(6.3±0.7),and kept excellent glycemic control without any medication.Conclusion Short-term CSII intensive therapy can significantly improve the first-phase insulin secretion and restore the natural history to a early term of newly diagnosed type 2 dibetes in different degree.更多还原