短期胰岛素泵强化治疗对初诊2型糖尿病患者糖脂代谢及胰岛β细胞功能的影响

目的:探讨短期胰岛素泵强化治疗对初诊2型糖尿病(type 2 diabetes mellitus,T2DM)患者糖脂代谢及胰岛β细胞功能的影响。方法:将74例初诊T2DM患者随机分为对照组与研究组,每组各37例。对照组给予常规治疗,研究组给予胰岛素泵短期强化治疗,观察两组治疗前后血糖、血脂指标及胰岛β细胞功能的变化。结果:治疗后,两组空腹血糖(FPG)、糖化血红蛋白(Hb Alc)、总胆固醇(TC)、甘油三酯(TG)及低密度脂蛋白胆固醇(LDL-C)水平较治疗前明显下降,高密度脂蛋白胆固醇(HDL-C)水平明显升高,且研究组改善程度更明显(P<0.05)。治疗后,两组胰岛素曲线下面积(AUC)、稳态模型评价-胰岛β细胞功能(HOMA-β)及第0.5 h胰岛素浓度与血糖浓度的比值(I30/G30)较治疗前明显变大,稳态模型评价-胰岛素抵抗(HOMA-IR)明显变小,且研究组改善程度更明显(P<0.05)。结论:对于初诊T2DM患者,短期胰岛素泵强化治疗能改善血糖、血脂水平,同时有助于修复功能受损的胰岛β细胞。

Effect of short-term continuous subcutaneous insulin infusion treatment on the glucolipid metabolism and islet beta-cell function of first-visit patients with T2DM

Objective:To explore the effect of short-term continuous subcutaneous insulin infusion treatment on the glucolipid netabolism and islet beta-cell function of first-visit patients with type 2 diabetes mellitus (T2DM).Methods:Totally 74 first-visit T2DM patients were randomly assigned into control group (n =37) and research group (n =37).The patients in control group were given routine treatment,while those in research group given short-term continuous subcutaneous insulin infusion treatment.The changes of blood glucose,blood lipids and islet beta-cell function were all observed in two groups before and after treatment.Results:After treatment,the levels of fasting blood glucose (FPG),glycosylated hemoglobin (HbAlc),total cholesterol (TC),triglyceride (TG) and low density lipoprotein cholesterol (LDL-C) all went down,while that of high density lipoprotein cholesterol (HDL-C) up in two groups when compared with pre-treatment,and the improvement degree of research group was more significant (P ＜ 0.05).After treatment,the area under the curve (AUC) of insulin,homeostasis model assessment-islet beta-cell function (HOMA-β) and the ratio of I30/G30 increased,whereas homeostasis model assessment insulin resistance (HOMA-IR) decreased significantly in two groups when compared with pre-treatment,and the improvement degree of research group was more significant (P ＜0.05).Conclusion:For first-visit T2DM patients,short-term continuous subcutaneous insulin infusion treatment can impove the glucolipid metabolism,and is conductive to repair of injured islet beta cells.