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胰岛素强化治疗对初诊2型糖尿病患者胰岛β细胞功能和胰岛素抵抗的影响

Effect of gradient intensive insulin treatment on the β cell function and insulin resistance in newly diagnosed type 2 diabetes mellitus

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【作者】 阮丹杰杨正强王雪琴魏靖李宏亮

【Author】 RUAN Dan-jie,YANG Zheng-qiang,WANG Xue-qin,et al.Department ofEndocrinology,The First Hospital of Huairou,Beijing 101400,China

【机构】 北京市怀柔区第一医院内分泌科卫生部中日友好医院内分泌科

【摘要】 目的探讨阶梯式胰岛素强化治疗对初诊2型糖尿病(T2DM)患者胰岛β细胞功能和胰岛素抵抗(IR)的影响及机制。方法初诊T2DM患者61例,进行为期2周的胰岛素强化治疗和后续10周的预混胰岛素治疗,比较治疗前后FPG、2hPG、HbA1c、FIns、2hIns、FG-P、2hC-P、TC、TG、胰岛β细胞分泌指数(HOMA-β)和胰岛素抵抗指数(HOMA-IR)的变化。结果治疗后患者FPG、2hPG、HbA1c和HOMA-IR显著下降,而FIns、2hIns、FC-P、2hC-P和HOMA-β显著上升。结论对血糖明显升高的初诊T2DM患者,短期胰岛素强化治疗及后续数周预混胰岛素皮下注射治疗可有效控制血糖,明显改善胰岛β细胞功能并减轻IR。

【Abstract】 Objective To investigate the effects of intensive insulin treatment on the β cell function and insulin resistance in newly diagnosed T2DM and to identify its mechanism.Methods 61 newly diagnosed T2DM cases were treated with continuous subcutaneous insulin infusion(CSII) for 2 weeks and with succedent premixed insulin treatment for 10 weeks.The fasting and postprandial plasma glucose, hemoglobin A1C(HbA1c),serum cholesterol,triglyceride,HOMA-β and HOMA-IR were compared between Pre-and Post-treatment.Results After intensive insulin treatment,levels of FPG,HbA1 c and HOMA-IR were lower significantly and levels of FIns,2hIns,FC-P,2hC-P,HOMA β were higher significantly(P<0.05 or P<0.01 ).Conclusions For newly diagnosed T2DM with more severe hyperglycemia,the short-term CSII and succedent premixed insulin treatment for several weeks can validly control hyperglycemia,evidently improve β-cell function and relieve IR.

  • 【文献出处】 中国糖尿病杂志 ,Chinese Journal of Diabetes , 编辑部邮箱 ,2009年07期
  • 【分类号】R587.1
  • 【被引频次】9
  • 【下载频次】30
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