2型糖尿病胰岛素治疗的时机

早期胰岛素强化治疗控制血糖,通过减轻糖毒性、脂毒性以及控制炎症,可以改变糖尿病并发症的自然病程,具有持久益处.因此,现在对于2型糖尿病胰岛素治疗的理念已经发生了很大变化,特别是对于诱导病情缓解和口服用药失效的2型糖尿病患者;为尽早和尽可能使血糖达标及恢复β细胞功能,应尽早启用胰岛素治疗.

Insulin initiation in type 2 diabetes

Large-scale clinical trials have demonstrated that metabolic control achieved early in the course of diabetes can substantially help preventing the onset and slowing down the progression of diabetes and the associated microvascular complications. Various strategies incorporating the use of insulin early in the course of the disease have been developed to meet this goal and to compensate for the progression of β-cell failure. We believe that insulin suppresses inflammation and also reduces glucotoxicity and lipotoxicity, and thus exerts a pivotal and beneficial role. Comprehensive metabolic control, especially when instituted earlier, may alter the natural history of diabetic complications. Therefore, physicians are encouraged to take early and intensive interventions with insulin therapy for patients with type 2 diabetes, especially when attempting to induce "remissions" or in patients suboptimally controlled with oral medications.