2型糖尿病患者经甘精胰岛素干预后空腹胰岛素及半胱氨酸水平临床分析

【目的】观察并比较使用不同剂量甘精胰岛素的2型糖尿病（type 2 diabetes mellitus,T2DM）患者空腹胰岛素（fastinginsulin,FINS）、C-肽（C-peptide,C-P）及同型半胱氨酸（homocysteine,Hcy）水平。【方法】T2DM患者80例,使用甘精胰岛素降糖治疗,血糖达标后继续治疗2个月,依据胰岛素使用剂量分为：低剂量组（LD）、中剂量组（MD）和高剂量组（HD）,检测各组FINS、C-P、空腹血糖（fasting plasma glucose,FPG）及Hcy水平,比较并分析其差异。【结果】三组在年龄、HbA1c、FPG、病程方面比较无统计学差异（P〉0.05）。三组C-P水平比较无统计学差异（P〉0.05）。FINS水平存在差异：MD组高于LD组（P〈0.01）,HD组高于MD组（P〈0.01）。三组间Hcy水平亦存在不同：MD组高于LD组（P〈0.05）,HD组高于MD组（P〈0.05）。【结论】FINS及Hcy水平与胰岛素使用剂量呈正相关,合理联合用药,应用尽可能小剂量的胰岛素达到理想的血糖控制目标,能够延缓或减轻糖尿病血管并发症的发生。

Fasting insulin and homocysteine levels in type 2 diabetes treated with insulin glargine

[Objective] Observe and compare the levels of fasting insulin （FINS）, C-peptide （C-P） and homocysteine （Hcy） in type 2 diabetes （T2DM） patients using different doses of insulin glargine. [Methods] 80 cases of T2DM patients using insulin glargine with satisfactory glycemic control, after two months, the patients were divided into three groups based on insulin dose： Low Dose group （LD）, Medium Dose group （MD） and High Dose group （HD）. Detect each group in FINS, C-P, fasting plasma glucose （FPG） and Hcy levels, compare and analyze the differences. [Results] There were no statistical significant differences between the three groups in age, HbAlc, FPG and course of disease, （P 〉 0.05）. The C-P levels in the three groups were not significantly different （P 〉 0.05）, but the FINS levels were significantly different： the MD group was higher than the LD group（P 〈 0.01 ）, the HD group was higher than the MD group（P 〈 0.01 ）. Also, there were differences in Hcy levels among the three groups： the MD group was higher than the LD group（P 〈 0.05 ）, the HD group was higher than the MD group（P 〈 0.05）. [Conclusion] There was a positive correlation between the FINS,Hcy levels and insulin dose. Therefore, combine reasonably, to achieve the desired blood sugar control target using as small dose of insulin as possible, can delay or reduce the occurrence of diabetic vascular complications.