初诊2型糖尿病患者两种胰岛素强化治疗临床观察

目的探讨短期胰岛素强化治疗对伴高血糖初发2型糖尿病患者的临床疗效及其对胰岛B细胞功能的影响。方法对78例初诊2型糖尿病（T2DM）患者随机分为持续胰岛素皮下输注（CSII）组和多次胰岛素皮下注射（MSII）组进行强化治疗2周，测定治疗前后空腹及馒头餐后2h血糖及胰岛素，并计算胰岛素分泌指数（HOMA—B）和胰岛素抵抗指数（HOMA—IR），观察两组治疗达标时间，胰岛素用量及对胰岛B细胞功能的影响。结果两组患者治疗期间FPG和2hPC比较无显著差异，胰岛素用量和达标时间有统计学意义，低血糖发生率两组间有统计学意义，两组治疗后HOMA．8较治疗前增高，HOMA—IR均较治疗前降低，差异具有显著性（P〈0．05）。结论短期CSII和MSII治疗均可改善新诊断2型糖尿病（T2DM）患者B细胞功能，减轻胰岛素抵抗，CSII较MSII临床效果好，达标快，胰岛素用量少，低血糖发生率低。

The Clinical Observation of Two Methods of Insulin Intensive Treatment for Patients with Newly Diagnosed Type 2 Diabetes

Objective To study the effects of short-term intensive insulin treatment on the β cell function and clinical effects in newly diagnosed type 2 diabetic patients. Methods 78 newly diagnosed type 2 diabetic patients were randomly divided into two groups ： continuous subcutaneous insulin infusion （ CS II ） and multiple dally infusion （ MS II ）, and were treated by CS II for 2 weeks. The levels of fasting plasma glucose（FPG） ,2 hours postprandial glucose（2hPG） were detected before and after the treatment. HOMA-IR and HOMA-β were calculated. The initial time and the dosage of insulin, the functions of islet cells were observed. Results There were no significant differences in FPG and 2hPG in two groups. The initial time and the dosage of insulin, HOMA-IR and HOMA had statistical significance（ P 〈 0.05）. Conclusion The excellent glycemic control and improvement of beta-cell function can be induced by short-term CSII intensive therapy in newly diagnosed type 2 diabetic patients.