C肽与血糖比值对糖尿病分型及治疗的意义

目的 :探讨C肽与血糖比值 (C/GR)对糖尿病分型及治疗的意义。方法 :对 19例 1型糖尿病和 136例2型糖尿病患者进行空腹和糖负荷后 30 ,6 0 ,12 0 ,180min的血糖和血浆C肽测定 ,将 2型糖尿病患者分为两个亚组 (非胰岛素治疗组和胰岛素治疗组 )。动态观察各组糖尿病患者空腹和糖负荷后各时点的C/GR。结果 :1型糖尿病组空腹和糖负荷后各时点的C/GR均显著低于 2型糖尿病组 (P <0 .0 1) ,其比值的变化趋势不同于 2型糖尿病组。 2型糖尿病两亚组C/GR的变化趋势相同 ,但胰岛素治疗组各时点的比值均显著低于非胰岛素治疗组(P <0 .0 1)。结论 :C肽与血糖比值可作为评定胰岛功能指标 ,并且对糖尿病的分型及治疗有指导意义 ,对该值较低的 2型糖尿病患者应给予胰岛素治疗

Significance of Ratio of C-Peptide to Blood Glucose in the Classification and Therapy of Diabetes Mellitus

Objective: Our aim was to investigate the significance of ratio of plasma c-peptide to blood glucose ratio (C/GR) in the classification and therapy of diabetes mellitus. Methods:Blood glucose and plasma c-peptide were determined before and 30,60,120,180 minutes after the start of the glucose load in 19 patients with type 1 diabetes and 136 with type 2 diabetes. Those with type 2 diabetes were divided into 2 subgroups according to the final therapy (the insulin-treated subgroup and the non-insulin-treated subgroup).The C/GR before and after the glucose load in each group were observed. Results:The ratio either before or after the glucose load of the type 1 diabetes group were significantly lower than those of the type 2 diabetes group.The changes of C/GR in these 2 groups were different. The changes of the ratio in the two subgroups of type 2 diabetes were same, but the ratio either before or after the glucose load of the insulin-treated subgroup of type 2 diabetes were significantly lower than those of the non-insulin-treated subgroup. Conclusion:The ratio of plasma c-peptide to blood glucose may be used in the evaluation the islets function and the classification and therapy of diabetes mellitus. The patients with type 2 diabetic patients and lower C/GR should received insulin.