短期胰岛素泵强化治疗对不同病程2型糖尿病胰腺β细胞功能的影响

目的观察短期胰岛素泵强化治疗对不同病程2型糖尿病（T2DM）患者胰岛B细胞功能的影响。方法收集T2DM患者183例，分为I组（新诊断且未接受治疗的T2DM）60例、II组（病程≤3年）60例及Ⅲ组（病程〉3年）63例。所有患者均采用短期胰岛素泵强化治疗，比较治疗前后空腹血糖、餐后2h血糖、C肽、B细胞功能指数（Homa-β）改善率，胰岛素抵抗指数（Homa-IR）改善率。结果各组患者治疗后空腹血糖、餐后2h血糖及空腹C肽均获得显著改善，与治疗前相比差异均有统计学意义（P均〈0．05）。治疗后各组β细胞功能及胰岛素抵抗均获得显著改善，各组间Homa-β及Homa-IR改善率差异有统计学意义（胸〈0．05）。结论短期胰岛素泵强化治疗可以有效控制不同病程患者的血糖，并且对于β细胞恢复及逆转胰岛素抵抗具有一定作用；患者病程越短，上述作用越明显。因此，建议有条件的T2DM患者，尽早采用短期胰岛素泵强化治疗。

The Influence of Short-term Intensive Treatment on Pancreatic Function by Insulin Pump to Type 2 Diabetes Mellitus with Different Course of Disease

Objective To observe the influence of short-term intensive treatment on pancreatic function by insulin pump to Type 2 Diabetes Mellitus （T2DM） with different course of disease. Methods 183 cases of T2DM were collected and divided into Group I （60 cases, new diagnosed and without any treatment）, Group II （60 cases, course of disease ≤ 3 years） and Group III （63 cases, course of disease〉3 years）. All the patients accepted intensive treatment by insulin pump. We compared the fasting plasma glucose （FPG）, 2-hour postprandial blood glucose （2 h PG）, C-peptide, the improvement rate of Homa- 15 and Homa-IR. Results The FPG, 2 h PG, C-peptide were improved in each group compared to those before the treatment （All P〈0.05）. The function of β cells and insulin resistance were improved in each group after the treatment with statistical significance （All P〈0.05）. Conclusion Short-term intensive treatment by insulin pump could improve the function of B cells and insulin resistance in pancreas. The patients with shorter course of disease could benefit more from it. So, we suggest that the patients with T2DM should accepted short-term intensive treatment by insulin pump if it is possible.