严格血糖控制对新诊2型糖尿病胰岛素分泌功能的影响

目的　研究严格血糖控制对新诊断2型糖尿病患者胰岛β细胞胰岛素分泌功能的影响。方法　新诊断的2型糖尿病患者89例分为胰岛素强化治疗组(A组)和口服降糖药组(B组) ,随访观察两组患者空腹C肽(FCP)及餐后2hC肽(2hPCP)的变化。结果　A组胰岛素强化治疗半年时FCP(1 .2±1 .0 )nmol/L和2hPCP(4. 3±1. 1)nmol/L与治疗前FCP :(0 .8±0 . 4 )nmol/L ,2hPCP :(3. 0±1. 0 )nmol/L]比较明显升高(P <0 . 0 5 ) ;随访1年FCP :(1. 4±0 . 8)nmol/L ,2hPCP :(5 .0±1 .9)nmol/L]仍在继续升高,与治疗前比较差异有统计学意义(P <0 .0 5 ) ,与半年FCP :(1. 2±1 .0 )nmol/L ,2hPCP :(4. 3±1 .1)nmol/L]比较(P <0 . 0 5 )仍有统计学意义,第2年FCP :(1 .3±1. 1)nmol/L ,2hPCP :(4 .8±1 .1)nmol/L]、3年FCP :(1. 3±0. 3)nmol/L ,2hPCP :(4 .8±1 .6 )nmol/L]、4年FCP :(1 .3±1. 0 )nmol/L ,2hPCP :(4 .6±1 .0 )nmol/L]渐下降,但与治疗前比较差异仍有统计学意义(P <0 . 0 5 )。B组随访半年FCP :(0 . 9±1 .3)nmol/L ,2hPCP :(3 .1±1 .1)nmol/L]较治疗前FCP :(0. 8±0 . 4 )nmol/L ,2hPCP :(3.0±1 .1)nmol/L]有所升高,但无统计学意义;第1年FCP :(1. 2±0 . 9)nmol/L ,2hPCP :(4 .4±2 .0 )nmol/L]时?

Effect of strict glycemic control on islet β-cell function in newly-diagnosed type 2 diabetic patients

Objective To study the effect of strict glycemic contro l on the β-cell function in newly-diagnosed type 2 diabetic patients.Me thods Eighty-nine newly-diagnosed type 2 diabetic patients with poor glycemic control (fasting blood glucose≥11.1 mmol/L) were divided into intensi ve insulin treatment group and oral hypoglycemic agents (OHA) group.The changes of the levels of blood c-peptide in fasting (FCP) and postprandial 2h (2 hPCP )were observed after treatment.Results In group A the levels of FCP and 2 hPCP were significantly increased after 0.5 year FCP:(1.2±1.0) nmol/L,2 hPCP:(4.3±1.1)nmol/L],compared with before the treatment FCP:(0.8±0.4)nmol/L,2 hPCP:(3.0±1.0)nmol/L] P<0.01, after one year FCP:(1.4±0.8)nmol/L,2 hPCP:(5.0±1.9)nmol/L] comp ared with befo re treatment P<0.01;compared with 0.5y FCP:(1.2±1.0)nm ol/L,2 hPCP:(4.3±1.1)nmol/L]P<0.05,after 2 years they w ere decreased gradually,but a significant difference remained between before tre atment and after 4 years (P<0.05).In group B the levels of FCP and 2hPCP were significantly increased after one year FCP:(1.2±0.9)nmol/L ,2 hPCP:(4.4±2.0)nmol/L],compared with before treatment P<0.01; after 2 years they were decreased gradulally, after 4 year they had no s ign ificant difference compared with before treatment.Conclusion A strict blood sugar control by intensive insulin treatment or by oral hyoglycemic ag ent is able to effectively improve the islet β-cell′s function of the newly d iagnosed type 2 diabetics,but the intensive insulin treatment can improve more a nd keep longer time.