短期诺和锐强化治疗对初诊2型糖尿病患者胰岛β细胞功能的影响

目的　探讨短期诺和锐强化治疗对初诊2型糖尿病(T2DM)患者胰岛β细胞功能和血糖控制的影响。　方法　对45例初诊T2DM患者进行为期两周的诺和锐强化治疗,分析比较治疗前后空腹(FPG)及餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)、静脉葡萄糖耐量试验时第一时相胰岛素及C肽分泌和胰岛素及C肽曲线下面积、胰岛素抵抗指数、胰岛素分泌指数、胰岛素敏感指数、空腹胰岛素(FIns)与FPG比值。　结果　诺和锐强化治疗后,FPG、2 hPG、HbA1c均较治疗前明显下降(P<0.01);空腹及第一时相胰岛素和C肽的分泌、胰岛素和C肽曲线下面积、FIns与FPG比值、胰岛素分泌指数、胰岛素敏感指数均较治疗前明显升高(P<0.01)。胰岛素抵抗指数较治疗前明显下降(P<0.01)。　结论　短期诺和锐强化治疗可显著改善初诊T2DM患者胰岛β细胞功能。

The effects of transient intensive insulin aspart treatment on beta-cell function in newly diagnosed type 2 diabetic patients

Objective To study the effect of transient intensive insulin aspart treatment(IIAT)on beta-cell function and plasma glucose in newly diagnosed type 2 diabetic patients. Methods (Forty)-five newly diagnosed type 2 diabetic patients were treated by 2 weeks intensive insulin aspart treatment. The levels of fasting plasma glucose(FPG), 2 hours postprandial glucose(2 hPG), (glycosylated) hemoglobin A_1c(HbA_1c), first-phase secretion of insulin and C-peptide, the mean area under the curve(AUC)of insulin and C-peptide, insulin resistance index (HOMA-A), insulin secretion index (HOMA-B), insulin sensitivity index(ISI)and the ratio of fasting insulin to fasting glucose(FIns/FPG)were compared before and after transient intensive insulin aspart treatment. Results After the treatment, FPG (14 vs 6 mmol/L), 2 hPG (20 vs 8 mmol/L), HbA_1c (11% vs 10%)and HOMA-A (0.32 vs 0.25)were significantly decreased (all P<0.01); fasting and first-phase secretion of insulin and C-peptide,AUC of insulin(AUC_(Ins)) and C-peptide(AUC_(cp)), FINS/FPG, HOMA-B and ISI were significantly increased (P<0.01). Conclusion The transient intensive insulin aspart treatment can effectively improve the beta-cell function in newly diagnosed type 2 diabetic patients.