胰岛素强化治疗对初诊断2型糖尿病患者胰岛功能的影响

目的了解短期胰岛素强化治疗对初诊断2型糖尿病患者胰岛α细胞及β细胞功能的影响。方法选取初诊断的2型糖尿病患者30例,对入选的患者给予胰岛素强化治疗(甘精胰岛素+三餐前速效人胰岛素类似物或胰岛素泵),治疗前后均行C肽释放试验(馒头餐试验),检测空腹、餐后半小时及餐后2 h的胰高血糖素、C肽及静脉血糖值。结果与强化治疗前相比,患者各时点静脉血糖明显下降,强化治疗后HOMA-IR指数均有显著降低(P0.05),而HOMA-β指数显著升高(P0.05),C肽血糖净增比(△CP30/△G30,△CP120/△G120)均有上升(P0.05),各时点CP/胰高血糖素比显著升高(P0.05);结论胰岛素短期强化治疗对初诊断的2型糖尿病患者的β细胞及α细胞功能均有改善作用,并能部分改善胰岛素抵抗。

Effect of intensive insulin therapy on the islet function in patients with newly diagnosed type 2 diabetes melli-tus

Objective To observe the changes of αand βislet cell function by short-term intensive insulin therapy in patients with newly diagnosed type 2 diabetes Mellitus （T2DM）.Methods 30 patients with newly diag-nosed with T2DM were selected.The patients were allocated to receive intensive insulin therapy （insulin glargine and short-acting insulin analogues /insulin pump before each meal ） .C-peptide test （ steamed bread meal test ） was per-formed before and after treatment for all patients .The level of glucagon ,C-peptide and venous blood glucose were de-tected at the time of fasting,0.5h and 2 h after the meal.Results The levels of venous blood glucose at different time point and HOMA-IR were decreased after the intensive treatment （p〈0.05）,while the index of HOMA-βwere signif-icantly increased （p〈0.05）.The ratio of △CP30/△G30,△CP120/△G120 and CP/glucagon at each time point were increased （p〈0.05）,Conclusion Short-term intensive insulin therapy could improve the function of αandβislet cell in patients with newly diagnosed T 2DM.