Functional status of pancreatic islet in acute leukemia.

Using enzymatic assay and radioimmunoassay, we studied the functional status of pancreatic islet in 50 patients with acute leukemia. Oral glucose tolerance test and insulin and C peptide release were made in 40 patients before and after treatment .14 patients who revealed diabetic curve and delayed insulin and C peptide release before treatment showed normal values in 6 after therapy. Five patients with impaired glucose tolerance and decreased insulin and C peptide release before treatment showed normalization of these parameters following therapy. Five patients with normal pretreatment values disclosed abnormal post-treatment results. The remaining 16 patients displayed normal results both before and after therapy. Anti-insulin antibodies were negative, and glucagon level was normal in all the 50 patients. The red cell insulin receptor binding rate analysed in 47 patients was significantly higher than in controls (P< 0.001). We considered that the disturbed glucose metabolism in acute leukemia was not     

EFFECTS OF GLUCAGON ON ISLET β CELL FUNCTION IN PATIENTS WITH DIABETES MELLITUS

Objective To evaluate islet β cell response to intravenous glucagon ( a non-glucose secretagogne) stimulation in diabetes mellitus. Methods Nineteen patients with type 1 diabetes (T1D) and 131 patients with type 2 diabetes (T2D) were recruited in this study. T2D patients were divided into two groups according to therapy: 36 cases treated with insulin and 95 cases treated with diet or oral therapy. The serum C-peptide levels were determined at fasting and six minutes after intra-venous injection of 1 mg of glucagon.Results Both fasting and 6-minute post-glucagnn-stimulated C-peptide levels in T1D patients were significantly lower than those of T2D patients (0. 76 ± 0.36 ng/mL vs. 1.81 ± 0. 78 ng/mL, P < 0. 05 ; 0. 88 ± 0. 42 ng/mL vs.3.68 ±0.98 ng/mL, P <0. 05). In T1D patients, the C-peptide level after injection of glucagon was similar to the fast-ing leveL In T2D, patients treated with diet or oral drug had a significantly greater fasting and stimulated C-peptide level than those patients received insulin therapy (2. 45±0. 93 ng/mL vs. 1.61±0. 68 ng/mL, P <0. 05 ; 5.26±1.24 ng/mLvs. 2. 15±0. 76 ng/mL, P < 0. 05 ). The serum C-peptide level after glucagon stimulation was positively correlated with C-peptide levels at fasting in all three groups ( r = 0. 76, P < 0. 05 ).Conclusions The 6-minute glucagon test is valuable in assessing the function of islet β cell in patients with diabetes mellitus. It is helpful for diagnosis and treatment of diabetes mellitus.     

EFFECTS OF GLUCAGON ON ISLET β CELL FUNCTION IN PATIENTS WITH DIABETES MELLITUS

Objective To evaluate islet β cell response to intravenous glucagon(a non-glucose secretagogue)stimulation in diabetes mellitus.Methods Nineteen patients with type 1 diabetes(T1D)and 131 patients with type 2 diabetes(T2D)were recruited in this study.T2D patients were divided into two groups according to therapy:36 cases treated with insulin and 95 cases treated with diet or oral therapy.The serum C-peptide levels were determined at fasting and six minutes after intravenous injection of 1 mg of glucagon.Results Both fasting and 6-minute post-glucagon-stimulated C-peptide levels in T1D patients were significantly lower than those of T2D patients(0.76±0.36 ng/mL vs.1.81±0.78 ng/mL,P<0.05;0.88±0.42 ng/mL vs.3.68±0.98 ng/mL,P<0.05).In T1D patients,the C-peptide level after injection of glucagon was similar to the fasting level.In T2D,patients treated with diet or oral drug had a significantly greater fasting and stimulated C-peptide level than those patients received insulin therapy(2.45±0.93 ng/mL vs.1.61±0.68 ng/mL,P<0.05;5.26±1.24 ng/mL vs.2.15±0.76 ng/mL,P<0.05).The serum C-peptide level after glucagon stimulation was positively correlated with C-peptide levels at fasting in all three groups(r=0.76,P<0.05).Conclusions The 6-minute glucagon test is valuable in assessing the function of islet β cell in patients with diabetes mellitus.It is helpful for diagnosis and treatment of diabetes mellitus.     

Effects of glucagon on islet beta cell function in patients with diabetes mellitus

Objective To evaluate islet β cell response to intravenous glucagon （ a non-glucose secretagogue） stimulation in diabetes mellitus. Methods Nineteen patients with type 1 diabetes （T1 D） and 131 patients with type 2 diabetes （T2D） were recruited in this study. T2D patients were divided into two groups according to therapy： 36 cases treated with insulin and 95 cases treated with diet or oral therapy. The serum C-peptide levels were determined at fasting and six minutes after intra- venous injection of 1 mg of ghicagon. Results Both fasting and 6-minute post-ghicagon-stimulated C-peptide levels in T1D patients were significantly lower than those of T2D patients （0. 76±0. 36 ng/mL vs. 1.81±0. 78 ng/mL, P 〈 0.05 ; 0.88±0.42 ng/mL vs. 3.68±0. 98 ng/mL, P 〈 0. 05 ）. In T1D patients, the C-peptide level after injection of ghicagon was similar to the fasting level. In T2D, patients treated with diet or oral drug had a significantly greater fasting and stimulated C-peptide level than those patients received insulin therapy （2.45±0. 93 ng/mL vs. 1.61±0. 68 ng/mL, P 〈 0.05 ; 5.26±1.24 ng/mL vs. 2.15±0.76 ng/mL, P 〈 0.05 ）. The serum C-peptide level after ghicagon stimulation was positively correlated with C-peptide levels at fasting in all three groups （ r = 0.76, P 〈 0.05 ）. Conclusions The 6-minute ghicagon test is valuable in assessing the function of islet β cell in patients with diabetes mellitus. It is helpful for diagnosis and treatment of diabetes mellitus.     

Autologous hematopoietic stem cell transplantation and conventional insulin therapy in the treatment of children with newly diagnosed type 1 diabetes: long term follow-up

Background It has been indicated that autologous hematopoietic stem cell transplantation （AHST） is a promising treatment to adults with type 1 diabetes, however, the application of AHST therapy to children with type 1 diabetes still needs more data. The aim of this study was to assess the clinical effect of immune intervention combined with AHST and conventional insulin therapy in the treatment of children with newly diagnosed type 1 diabetes. Methods This 1：2 matched case-control study was comprised of 42 children who were newly diagnosed with type 1 diabetes in the Department of Endocrinology, Beijing Children＇s Hospital from 2009-2010. The case group included 14 patients, who were treated with AHST within the first 3 months after being diagnosed with diabetes at request of their parents during 2009-2010. The control group included 28 patients with newly diagnosed type 1 diabetes at the same period of hospitalization. We compared the baseline and follow-up data of them, including ketoacidosis onset, clinical variables （glycosylated hemoglobin （HbAlc）, insulin dosage and serum C-peptide）. Results The clinical characteristics of the patients was comparable between the case group and the control group. At 6-12 months （（10.7±4.2） months） after AHST treatment, we found 11 patients in the case group did not stop the insulin therapy, three cases stopped insulin treatment for 2, 3 and 11 months, respectively. No diabetic ketoacidosis （DKA） occurred after transplantation in all the patients in the case group. HbAlc in the control group was significant lower than that in the case group （P 〈0.01）, while the insulin dosage and serum C-peptide were not significant different between the two groups （P 〉0.05）. In order to eliminate the honeymoon effect, we performed final follow-up at the 3-5 years （（4.2±1.8） years） after AHST treatment, and found that HbAlc in the control group was still lower than that in the case group （P 〈0.01）; however, the insulin dosage and serum C     

Effects of Metformin Combined with Cyproterone Acetate on Clinical Features, Endocrine and Metabolism of Non-obese Women with Polycystic Ovarian Syndrome

In order to explore the effects of metformin combined with cyproterone acetate (CPA) on the clinical features, endocrine and metabolism of the patients with polycystic ovarian syndrome (PCOS), 50 cases of non-obese PCOS were randomly subjected to CPA (CPA treatment group, n=25) and CPA metformin (n=25) treatment for 6 months. Before and after treatment the body mass index (BMI), waist:hip ratio (WHR), ovarian volume, serum gonadotrophin, and rogen andsex hormone-binding globulin (SHBG) levels, and fasting lipid, glucose and insulin levels were measured. The results showed that all of the parameters in two groups were similar before treatment. After treatment for 6 months in the CPA metformin group, BMI and WHR were significantly decreased, while insulin sensitivity was significantly decreased as compared with those before treatment. In CPA group, no significant changes were found before and after treatment. Combined use of CPA and metformin could result in the reduction of serum androstenedione and increases of serum SHBG levels as compared with the CPA treatment alone. It was concluded that combined use of CPA and metformin could improve the insulin sensitivity, and further suppress the hyperandrogenism in non-obese women with PCOS.     

Effect of Prepared Rhubarb on Insulin Resistance in Patients With Pregnancy Induced Hypertension

Objective: To investigate the effect of prepared rhubarb on insulin resistance in patients with pregnancy induced hypertension (PIH) and its mechanism. Methods: All the 92 patients accepted 75 g oral glucose tolerance test (OGTT) and insulin release test before and after treatment. These patients were divided into two groups (treated group and control group). Prepared rhubarb and nifedipine were given to the treated group, while nifedipine was given to the control group alone. Circulating endothelial cell (CEC), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) were measured and glucose area under curve (GAUC), insulin area under curve (IAUC), insulin sensitivity index (ISI) were calculated. And 30 normal pregnant women were selected as the healthy group. Results: CEC, TNF-a, IL-6, GAUC and IAUC of PIH patients were significantly higher than those of the normal healthy group; while ISI of PIH patients was significantly lower than that of the healthy group. ISI was significantly negatively correlat     

Insulin Resistance and Hypertension

The insulin sensitivity in hypertensive patients with normal glucose tolerance (NGT),impaired glucose tolerance (IGT) and type 2 diabetes mellitus (DM) and the insulin resistance (IR) under the disorder or grucose metabolism and hypertension were studied.by glucose tolerance test and insulin release test,insulin sensitivity index (ISI) and the ratio of area under glucose tolerance curve (AUCG) to area under insulin release curve (AUC1) were calculated and analyzed.The results showed that ISI was decreased to varying degrees in the patients with hypertension,the mildest in the group of NGT with hypertension,followed by the group of IGT without hypertension,the group of IGT with hypertension and DM(P=0).There was very significant difference in the ratio of AUCG/AUC1 between the hypertensive patients with NGT and controls (P=0).It was concluded that a significant IR existed during the development of IGT both in hypertension and nonhypertension.The increase of total insulin secretion (AUC1) was associated with nonhypertension simultaneously.IR of the hypertensive patients even existed in NGT and was worsened with the deterioration of glucose metabolism disorder,but the AUC1 in the HT group changed slightly.A relative deficiency of insulin secretion of dysfunction of β-cell of islet existed in IGT and DM of the hypertensive patients.     

Procedure and clinical assessments of malariotherapy:recent experience in 20 HIV patients

Objective To demonstrate the side effects of malariotherapy and to explore safe procedures in conduct of malariotherapy for human immunodeficiency virus (HIV) infected patients.Methods Twenty HIV/acquired immunodeficiency syndrome (AIDS) patients were selected for the study of malariotherapy and were intravenously infected with Plasmodia vivax to induce therapeutic malaria. Malaria was terminated with chloroquine after 10 -20 malarial febrile episodes. Clinical assessments were made before (baseline), during (malarial phase) and after (post) termination of malaria. The density of Plasmodia in peripheral blood from the HIV/AIDS patients were compared to that from HIV-negative naturally infected malarial patients who donated the blood for the therapeutically induced malaria. CD4 cell baseline levels were correlated to the severity of malarial symptoms and parasitemia.Results There were no significant differences of Plasmodium density between the HIV/AIDS patients injected with P, vivax and the HIV-negative blood donors. However, it was found that the HIV-positive patients had milder malarial symptoms and parasitemia with progressively lower CD4 cell baseline levels. All patients developed every day or every other day fever episodes with headache and shaking chill. These symptoms were well tolerated with the aid of anti-pyretic medications. Spleen and liver enlargement were seen in 15 of 20 and 4 of 20 patients respectively. Transitory liver effects with increase of serum glutamic-pyruvic transaminase were seen in 2 of 20 during malarial phase. Most patients experienced mild to medium anemia and 6 of 20 patients developed thrombocytopenia during malarial phase. All these side effects disappeared after termination of malaria or within one month thereafter. No complications occurred in these patients.Conclusions Therapeutically induced acute vivax malaria was well tolerated in 20 HIV-positive subjects who represented a range of CD4 cell levels from 1868/μ1 to 15/μ1. Malariotherapy did not induce complications while increasing CD4 cell levels in most treated HIV/AIDS patients (results published elsewhere).     

The State of Insulin Resistance in Patients with Nonalcoholic Fatty Liver and the Intervention with Gankangyin(肝康饮)

Objective: To explore the correlation of nonalcoholic fatty liver (NAFL) with insulin resistrandomly assigned into the treated group and the control group. They were treated with GKY and Silymarin for 3 months respectively. Oral glucose tolerance test (OGTT) and insulin release test (IRT) were conducted and insulin sensitivity indexes were determined before and after treatment. And 32 healthy nonalcoholic persons were enrolled and used as the healthy control group. Results: Before treatment, the levels of blood glucose and insulin at different time points in OGTT test, and the insulin resistance index (IRI) were significantly higher (P＜0.05 or P＜0.01) while insulin sensitivity index (ISI) and insulin active index (IAI) were lower ( P＜0.05 or P＜0. 01) in the NAFL patients than those in the healthy persons. After treatment, the abovementioned raised criteria were significantly Iowered ( P＜0. 05, P＜0.01) and the lowered criteria were significantly increased ( P＜0. 01) in the treated group, while in the control group all the criteria were insignificantly changed ( P ＞0.05 ). Conclusion: Evident insulin resistance exists in NAFL patients. GKY could increase the insulin sensitivity, thus improving the state of insulin resistance in NAFL patients.     

自体骨髓移植治疗儿童1型糖尿病

目的 探讨自体骨髓移植治疗1型糖尿病的有效性及安全性.方法 16例1型糖尿病患者采集自体骨髓并予以冻存;采用环磷酰胺+兔抗人胸腺细胞球蛋白方案预处理后经静脉回输骨髓.观察移植前后胰岛素注射剂量、糖化血红蛋白(HbA1c)水平、C肽水平、血糖水平及不良反应.结果 随访(62-365)d,中位随访时间265d,68.8％(11/16)患者术后停用胰岛素,开始停用胰岛素时间在骨髓移植后(5-114)d,中位时间为21d,最长停用胰岛素360d.11例停用胰岛素患者中2例于移植后2个月左右重新使用胰岛素,5例未停用者胰岛素用量均较移植前减少(P＜0.05).移植后患者C肽水平较移植前明显上升(P＜0.05),所有患者未出现长期骨髓抑制等严重不良反应.结论 自体骨髓移植治疗1型糖尿病,初步结果显示临床有效性及安全性,远期疗效有待进一步验证.     

胰岛素治疗对2型糖尿病病人胰岛β细胞功能的影响

①目的探讨胰岛素治疗对2型糖尿病病人胰岛β细胞功能的影响.②方法将100例病程超过10年,血糖控制不良的2型糖尿病病人,随机分为两组,A组给予常规治疗,B组给予胰岛素强化治疗,治疗前后应用放免法测C肽.③结果B组病人治疗后血C肽基础值及高峰值均明显高于治疗前(t=2.34.2.38,P＜0.05),A组病人治疗后血C肽基础值及高峰值较治疗前虽有增加,但差异无统计学意义(t=1.73,1.84,P＞0.05).B组治疗前后C肽变化较A组明显(t=2.23,2.13,P＜0.05).④结论病程超过10年的2型糖尿病病人及时采用胰岛素治疗有利于保护胰岛β细胞功能,减轻高血糖毒性.     

自体干细胞移植治疗糖尿病足胰岛功能变化研究

目的 探讨自体干细胞移植治疗糖尿病足胰岛功能的变化.方法 选择糖尿病足患者125例.术前采用胰岛素控制血糖,根据血糖控制情况分为两组:1组为全天血糖完全达标(三餐前血糖＜5.6 mmol/L,餐后2 h血糖＜7.8 mmol/L)63例;2组为全天血糖均高于正常(三餐前血糖＜9～10 mmol/L,餐后2 h血糖＜12～16 mmol/L)62例.均采用骨髓间质干细胞治疗糖尿病足.观察患肢的麻木、疼痛感、冷感、间歇性跛行是否好转,同时检测术后3 d、1周、2周、1个月、3个月的餐前及餐后2 h血糖、C-肽值,同时观察外用胰岛素用量的变化.观察有无不良反应发生.结果 术前1组患者餐前和餐后2 h血糖较2组均明显降低,差异有统计学意义(P＜0.05);术后3 d、1周、2周、1个月、3个月1组与2组患者餐前及餐后2 h血糖比较,差异均无统计学意义(P＞0.05).术后3 d两组患者胰岛素用量较术前均明显降低,差异有统计学意义(P＜0.05).术前1组患者胰岛素用量较2组无明显降低,差异无统计学意义(P＞0.05);术后3 d、1周、2周、1个月、3个月2组患者胰岛素用量较1组均明显降低,差异有统计学意义(P＜0.05).术前、术后3 d、1周、2周、1个月、3个月餐前和餐后2 h两组患者血C-肽水平比较,差异均无统计学意义(P＞0.05).结论 自体骨髓干细胞在糖尿病患者体内可以部分分化为胰岛β细胞,分化的程度可能与移植前全天血糖水平有关.     

胰腺干细胞和胰岛细胞在糖尿病 大鼠治疗中的疗效观察

目的 探讨大鼠胰腺干细胞与胰岛细胞移植在大鼠糖尿病治疗中的疗效。方法 通过链脲菌 素复制1 型糖尿病大鼠模型并随机分为胰岛细胞组和胰腺干细胞组。用胶原酶V 分别消化新生和成年大鼠 胰腺,Percoll 梯度离心分离胰岛细胞和胰腺干细胞。采用Bonner-Weir 法诱导胰腺干细胞分化,DTZ 染色 检测移植物纯度,AO/PI 检测移植物活性。分别记录手术前后大鼠血糖水平、胰岛素水平及移植物存活时 间;高糖刺激实验和腹腔糖耐量评价移植物功能;取各组大鼠移植部位标本行HE 染色和免疫组织化学染 色,观察组织形态学变化。结果 胰岛细胞组和胰腺干细胞组血糖分别在术后3 和5 d 恢复正常（P <0.05）, 两组大鼠术后不同时间点的血糖有差异（P <0.05）,胰腺干细胞组的降糖能力强于胰岛细胞组（P <0.05）。 两组大鼠移植后7 d 血清胰岛素水平均较术前升高（P <0.05）。高糖刺激实验表明,各组移植后15 和65 d 高糖刺激后的C 肽水平较刺激前升高（P <0.05）,胰岛细胞组移植后65 d 高糖刺激后C 肽水平低于胰腺 干细胞组（P <0.05）,胰岛素和C 肽水平监测结果表明胰腺干细胞组移植物胰岛素分泌维持时间长于胰岛 细胞组。移植后腹腔糖耐量实验结果表明移植物均功能良好。胰岛细胞组和胰腺干细胞组移植物的中位 存活时间分别为73 和88 d,Kaplan-Meier 曲线分析提示胰腺干细胞组移植物生存时间较胰岛细胞组延长 （P <0.05）。HE 染色提示肝脏门静脉移植区域可见新生血管包绕的胰岛细胞团,免疫组织化学染色证实细 胞团胰岛素阳性。结论 胰腺干细胞分化后经门静脉移植能安全有效地发挥降糖作用,疗效优于胰岛细胞 移植。     

格列吡嗪控释片治疗冠心病合并2型糖尿病的临床研究

目的对比格列吡嗪控释片与格列吡嗪速释片对冠心病合并2型糖尿病患者的有效性和安全性。方法选择60例冠心病合并2型糖尿病患者,随机分成2组,每组30例,分别给予格列吡嗪控释片和格列吡嗪速释片治疗,观察2组给药前后血糖、胰岛素、C肽、糖化血红蛋白的变化。结果格列吡嗪控释片每日服用1次的降糖效果与格列吡嗪速释片每日服用3次的降糖效果相同,控释片组胰岛素和C肽水平较低。结论格列吡嗪控释片对冠心病合并2型糖尿病患者有较好的降糖作用,安全有效,服用方便,又相对不引起高胰岛素血症。     

化疗对肿瘤患者血糖及胰岛β细胞功能影响的研究

目的了解化疗对肿瘤患者血糖及胰岛β细胞功能的影响,分析影响血糖变化的相关因素。方法 50例初次化疗的无糖尿病史的恶性肿瘤患者,全部患者第一周期化疗前、化疗后第2 d采血,检测空腹血糖、C肽及胰岛素水平。20例患者在第4个周期化疗后重复上述检查。比较第一周期化疗前后及第一周期前与第四周期化疗后血糖、C肽、胰岛素变化,同时分析化疗中各种因素对血糖影响。结果第一周期化疗后患者空腹血糖、C肽、胰岛素均显著高于化疗前水平(P0.01)。20例患者4个周期化疗后空腹血糖、C肽、胰岛素水平与首次化疗前比较,水平均有提高(P0.05);未见相关因素对血糖影响。结论化疗可引起患者血糖、胰岛素、C肽水平升高,导致胰岛素抵抗,可能诱发糖尿病。     

Clinical islet transplantation in type 1 diabetes mellitus: results of Australia's first trial

OBJECTIVE: To determine whether pancreatic islet transplantation can control diabetes and prevent severe life-threatening hypoglycaemia. DESIGN, SETTING AND PARTICIPANTS: A single-arm observation study of six patients undergoing islet transplantation. All patients had had type 1 diabetes mellitus for over 5 years and documented episodes of repeated severe hypoglycaemia. Islets were isolated from donor pancreases digested by Liberase. Separated islets were infused into the recipient's liver via the portal vein. Patients were immunosuppressed with daclizumab, sirolimus and tacrolimus. The transplants were performed at Westmead Hospital, NSW, between October 2002 and February 2005. MAIN OUTCOME MEASURES: Normal blood glucose control without administration of exogenous insulin; demonstration of islet function and abolition of hypoglycaemia. RESULTS: Five of the patients received two islet infusions, and the sixth was withdrawn after one infusion following a portal vein thrombosis. Three patients became insulin-independent, with excellent glycaemic control. Two had islet function with circulating C-peptide, improved glycaemic control, reduced insulin requirement and abolition of severe hypoglycaemia. However, over a 2-year period, graft function deteriorated. Recipients who were initially insulin free remained C-peptide positive but required supplemental insulin. Complications included one postoperative bleed, two portal vein thromboses (which resolved completely), presumed recurrence of tuberculosis in one patient, and deterioration in renal function in one patient. CONCLUSIONS: Islet transplantation is effective at improving glycaemic control and hypoglycaemia unawareness in the short to medium term. However, problems with long-term safety of immunosuppression, islet-induced thrombosis and early detection of loss of islet function remain to be addressed.     

成人胰岛细胞移植临床研究

目的建立新型成人胰岛细胞分离纯化方法,观察成人胰岛细胞移植的安全性与有效性。方法PFC与UW液双层冷藏胰腺,Liberase酶消化,COBE2991型专用胰岛细胞分离机分离及连续密度梯度纯化,获取高纯度与高活性的胰岛细胞。采用外科方法,将短期培养的胰岛细胞经门静脉移植到肝脏内。术后监测血糖与胰岛素用量、C肽与糖化血红蛋白水平以及肝肾功能,并与术前比较。结果42个胰腺成功分离胰岛细胞,平均数量28.5万IEQ、纯度95.7%、活率93.2%、刺激指数2.43,病原学结果均阴性。11例1型糖尿病患者实施成人胰岛细胞移植20次,每次移植平均胰岛数量为11200 IEQ/kg。采用无激素免疫抑制治疗。随访7个月~4年,7例完全撤除胰岛素,4例胰岛素用量较术前减少60%以上。术后血糖稳定维持在正常水平,C肽均超过0.5nmol/L,糖化血红蛋白基本正常,肝肾功能稳定维持正常,无胰岛移植并发症。结论新型成人胰岛细胞分离纯化方法可靠,成人胰岛细胞移植治疗1型糖尿病临床疗效较好,手术简捷,安全性好。     

自体骨髓干细胞移植治疗2型糖尿病的安全性及有效性

目的探讨自体骨髓干细胞(bone marrow stem cells,BMSCs)经胰背动脉移植治疗2型糖尿病(type 2 diabe-tes mellitus,T2DM)的有效性及安全性。方法回顾性分析2009年6月至2011年4月在我科住院符合纳入标准的6例2型糖尿病患者(3男3女),年龄(45.67±14.92)岁,实施自体骨髓干细胞移植。①动员骨髓;②采集骨髓;③分离骨髓干细胞;④将骨髓干细胞注入胰背动脉;⑤观察移植前后血糖、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、胰岛功能、C肽曲线下面积(area under curve for C-peptide,AUCC)及胰岛素用量等变化,记录治疗过程中及治疗后的不良反应;对干细胞移植的安全性及疗效进行评估。结果移植前后:①糖化血红蛋白由(10.33±2.78)%降至(7.05±0.90)%,有2例患者的糖化血红蛋白<7%;②空腹C肽(fasting C-peptide,FC-P)由(0.71±0.54)ng/ml升至(1.54±0.63)ng/ml(P<0.05),餐后2 h C肽(2 h postprandial C-peptide,2 h C-P)由(1.63±0.88)ng/ml升至(4.67±2.31)ng/ml(P<0.05),C肽曲线下面积由(2.29±1.31)ng/ml增至(6.05±2.94)ng/ml(P<0.05);③胰岛素用量由(27.17±13.08)U/d降到(18.63±7.04)U/d,其中2位患者停用皮下注射胰岛素改为口服药物降糖治疗;④自体骨髓干细胞移植过程中及术后随访均未观察到不良反应,移植前后肿瘤标志物及血淀粉酶均正常。结论自体骨髓来源干细胞移植可改善2型糖尿病患者的胰岛功能,减轻其对外源性降糖药物的依赖,且安全性可行。