胰岛素泵强化治疗初诊20例2型糖尿病的临床分析

目的观察短期胰岛素强化治疗初诊2型糖尿病的降糖效果及对胰岛β细胞功能的影响。方法对我科20例初诊的2型糖尿病患者检查进行为期10～18 d胰岛素泵强化治疗,比较治疗前后空腹血糖(FPG)及餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1 c)、血脂、胰岛素分泌第一时相(30 min C肽)。结果经胰岛素强化治疗后初诊2型糖尿病空腹、餐后血糖、糖化血红蛋白、血脂均较前明显下降(P<0.01);随防6个月,患者不同程度地恢复胰岛素第一时相分泌,胰岛β细胞的功能较前明显提高。结论初诊2型糖尿病应用胰岛素泵治疗可快速控制血糖及显著改善胰岛素分泌和增强外周组织对胰岛素的敏感性。

Study on application of insulin pump therapy in treatment of newly diagnosed 20 cases of type 2 diabetes

Objective To observe the efficacy of short-term intensive insulin therapy in treatment of newly diagnosed patients with type 2 diabetes and its effects on function of β cells of pancreatic islet.Methods The efficacy of 20 patients with newly diagnosed type 2 diabetes under a period of 10~18 days of insulin pump therapy was studied.Levels of fasting plasma glucose（FPG） and 2 h postprandial blood glucose（2 hPG）,glycosylated hemoglobin（HbA1c）,blood lipids and insulin secretion at first phase and C peptide area under the curve（AUC） were determined and their results before treatment were compared with those after treatment.Results Blood levels of fasting,postprandial glucose,glycosylated hemoglobin and lipids were significantly decreased in newly diagnosed patients with type 2 diabetes after intensive insulin therapy in comparison with those before the treatment（P0.01）.After follow-up for 6 months,the first phase secretion of insulin and β cell function of islet were restored in varying degrees in majority of patients.Conclusion The application of insulin pump therapy and rapid control of blood level of glucose in newly diagnosed patients with type 2 diabetes can significantly increase the insulin secretion and the sensitivity to insulin in peripheral tissues.