短期持续皮下胰岛素输注治疗初诊2型糖尿病的随访分析

目的：观察短期持续皮下胰岛素输注（CSII）对初诊2型糖尿病（T2DM）血糖控制的效果。方法：对179例初诊T2DM患者进行CSII治疗3周。以静脉葡萄糖耐量试验（IVGTT）对患者进行治疗前后自身对照，分析比较血糖（BG）、糖化血红蛋白（HbA_1c）、岛素（INS）C肽(C-P）的变化。停止治疗后0、3及8周分别重复监测上述指标。结果：纳入分析的159例患者应用CSII治疗前血糖控制均很差，平均空腹血糖（FPG）为（15.27±2.32）mmol?L^-1，餐后血糖（PPG）为（22.18±3.43）mmol?L^-1HbA_1c为14.95%±2.42%。CSII治疗3周结束时，FPG、PPG和HbA_1c均较治疗前明显下降，分别为（5.52±1.30）mmol?L^-1、（7.18±1.21）mmol?L^-1和10.86%±1.33%(P<0.001或P<0.05)。患者不同程度地恢复了胰岛素（INS）分泌第一时相。在CSII治疗停止后3及8周，FPG、PPG和HbA_1c较治疗前明显降低(P<0.001或P<0.05)。结论：初诊T2DM患者经CSII强化治疗3周有效者血糖得到良好控制。

Follow-up analysis of short-term continuous subcutaneous insulin infusion therapy for newly diagnosed type 2 diabetes mellitus

Objective To observe the effects of glycemic control in patients with newly diagnosed type 2 diabetes mellitus(T2DM) by continuous subcutaneous insulin infusion(CSII).Methods A total of 179 patients with newly diagnosed T2DM received 3 weeks' treatment of CSII.Before-after study in the same patient was applied.Intravenous glucose tolerance test(IVGTT) was performed,and blood glucose,HbA1c,insulin,C-peptide(C-P) were measured before and after CSII.The same index was observed 3 and 8 weeks after drug withdrawal.Results Of all 179 patients,159 cases were chosen.Before CSII,the average fasting plasma glucose(FPG) was(15.27±2.32)mmol·L-1,postprandial plasma glucose(PPG)was(22.18±3.43)mmol·L-1,and HbA1c was 14.95%±2.42%.3 weeks after CSII,FPG,PPG and HbA1c were significantly decreased(5.52±1.30)mmol·L-1,(7.18±1.21)mmol·L-1 and 10.86%±1.33%,respectively](P<0.001 or P<0.05).The patients had different degree restoration of the first-phase insulin secretion.3 and 8 weeks after drug withdrawal,FPG,PPG and HbA1c were significantly reduced(P<0.001 or P<0.05).Conclusion The excellent glycemic control can be induced by 3 weeks' treatment of CSII in newly diagnosed T2DM.