【摘要】 目的探讨胰岛素强化治疗后续降糖方案对2型糖尿病患者胰岛功能的影响.方法选取2型糖尿病患者137例,均给予胰岛素强化治疗,治疗14 d后将其随机分成3组,并采用不同的后续降糖方案,其中,基础胰岛素组48例,预混胰岛素组42例,磺脲类促泌剂组47例.分别于后续降糖治疗前、治疗3个月后检测空腹血糖、糖化血红蛋白、各血脂指标水平、空腹胰岛素水平;应用0～10 min静脉葡萄糖耐量试验测定急性胰岛素分泌反应指数.结果后续治疗后,基础胰岛素组、预混胰岛素组的胰岛β细胞功能指数(HOMA-β)、急性胰岛素分泌反应指数、胰岛素曲线下面积、低血糖发生率与磺脲类促泌剂组比较明显升高,差异具有统计学意义(P<0.05);但在基础胰岛素组与预混胰岛素组之间比较差异无统计学意义(P>0.05).治疗后各组患者空腹血糖、糖化血红蛋白、总胆固醇、甘油三酯、低密度脂蛋白、胰岛素抵抗指数(HOMA-IR)明显低于后续降糖治疗前,差异具有统计学意义(P<0.05); HOMA-β、急性胰岛素分泌反应指数、胰岛素曲线下面积明显高于后续降糖治疗前,差异具有统计学意义(P<0.01).结论胰岛素后续治疗方案适用于初诊2型糖尿病患者胰岛素强化治疗后的降糖治疗,在改善胰岛功能方面效果明显.更多还原

【Abstract】 Objective To investigate the effect of the follow-up hypoglycemic regimen of intensive insulin therapy on the islet function of type 2 diabetic patients. Method 137 patients with type 2 diabetes were selected. All patients were given intensive insulin treatment. After 14 days of treatment,they were randomly divided into three groups and adopted different follow-up hypoglycemic programs: basic insulin group 48 cases,premixed insulin group42 cases,sulfonylurea group 47 cases.Fasting blood glucose,glycosylated hemoglobin and blood lipid were measured before and 3 months after the follow-up hypoglycemic treatment; acute insulin secretion response index was measured by intravenous glucose tolerance test for 0 ～ 10 minutes. Results HOMA-β,acute insulin secretion response index,area under insulin curve and incidence of hypoglycemia in basic insulin group and premixed insulin group were significantly higher than those in sulfonylurea group (P<0.05),but there was no significant difference between basic insulin group and premixed insulin group (P > 0. 05). After treatment,fasting blood glucose,glycosylated hemoglobin,total cholesterol,triglyceride,low-density lipoprotein and HOMA-IR were significantly lower than those before follow-up hypoglycemic treatment (P < 0.05); HOMA-β,acute insulin secretion response index and area under insulin curve were significantly higher than those before follow-up hypoglycemic treatment (P< 0. 01). Conclusion Insulin therapy is more suitable for the newly diagnosed type 2 diabetic patients after intensive insulin therapy,and has obvious effect on improving the function of islets of Langerhans.更多还原