【摘要】 目的 对比老年2型糖尿病(DM)患者及老年成人隐匿性自身免疫性糖尿病(LADA)患者进行胰岛素强化方法治疗的胰岛β细胞功能和治疗效果。方法 选取2011年2月至2015年6月就诊的共44例2型DM患者作为DM组。选取同期的46例LADA患者作为LADA组。采用胰岛素强化治疗,对比两组患者治疗前后胰岛β细胞功能,治疗前后空腹及餐后1h和2h的C肽、胰岛素、糖化血红蛋白(HbA1c)、血糖水平。结果DM组患者治疗前后HOMA-IS显著高于LADA组患者,且差异均有统计学意义(P<0.05),两组患者治疗后HOMA-IS水平明显高于各组治疗前,且差异具有统计学意义(P<0.05)。DM组患者治疗前后的空腹、餐后1h和餐后2hC肽和胰岛素水平均明显高于LADA组患者,且差异均有统计学意义(P<0.05),两组患者治疗后空腹、餐后1h和餐后2hC肽和胰岛素水平均明显高于治疗前,且差异均有统计学意义(P<0.05)。两组患者治疗前后HbA1c、空腹血糖和2h血糖水平对比均无明显差异(P>0.05),两组患者治疗后HbA1c、空腹血糖和2h血糖水平均明显低于治疗前,且差异均有统计学意义(P<0.05)。结论 应用胰岛素强化方法治疗老年LADA患者在临床疗效方面明显优于2型DM患者。更多还原

【Abstract】 Objective To compare the β-cell function and clinical efficacy of intensive insulin therapy of elderly patients with type 2 DM and LADA. Methods 44 type 2 DM patients of our hospital between February 2011 and June 2015 were selected as DM group, while 46 LADA patients contemporaneous as LADA group. Intensive insulin therapy were applied to all patients, the p-cell function pre-treatment and post-treatment,fasting, 1 hour postprandial and 2 hours postprandial C-peptide, insulin, HbAlc, glucose pre-treatment and post-treatment were compared.Results The HOMA-IS level of DM group pre-treatment and post-treatment were all much higher than LADA group(P<0.05). The post-treatment HOMA-IS level of two groups were both much higher than pre-treatment(P<0.05). The pre-treatment and post-treatment fasting, 1 hour postprandial and 2 hours postprandial C-peptide, insulin level of DM group were much higher than LADA group(P<0.05). The post-treatment fasting, 1 hour postprandial and 2 hours postprandial C-peptide, insulin level were much higher than pre-treatment(P<0.05). The pre-treatment and post-treatment HbAlc, fasting glucose and 2 hours postprandial of two groups had no statistical difference(P>0.05). The post-treatment HbAlc, fasting glucose and 2 hours postprandial of two groups were much less than pre-treatment(P<0.05). Conclusion The effect of insulin intensive therapy on elderly patients with LADA is significantly better than that of patients with type 2 DM.更多还原