短期胰岛素强化治疗改善新诊断2型糖尿病患者胰岛β细胞功能研究被引量：3

A study of short-term intensive insulin treatment improving islet βcell function in newly diagnosed type 2diabetic patients

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摘要目的:探讨短期持续皮下胰岛素输注(CSII)对不同糖化血红蛋白(HbA1c)新诊断2型糖尿病人胰岛β细胞功能影响。方法:新诊断2型糖尿病患者60例,按HbA1c<8.5%;8.5%￣10.0%;>10.0%分为3组,予胰岛素泵强化治疗两周,治疗前后应用静脉葡萄糖耐量试验(IVGTT)测定0、1、2、4、6、10分钟胰岛素、血糖,计算Homa-β、Homa-IR和0￣10分钟胰岛素曲线下面积(AUC0￣10minINS)。结果:60例患者各自治疗前后空腹胰岛素水平无统计学差异,其余时间点治疗前后胰岛素水平差异均有统计学意义,AUC0￣10minINS由治疗前(93.6±82.7)#IU/ml增加至(153.4±97.5)#IU/ml,差异有统计学意义(P=0.000)。三组间治疗后与治疗前各点胰岛素差值比较,HbA1c>10.0%组0分钟基础胰岛素值改善明显,其余时间点三组间疗效的差异无统计学意义。结论:早期采用胰岛素强化治疗可以使不同HbA1c的新诊断2型糖尿病第一时相胰岛素分泌为代表的胰岛β细胞功能改善。 Objective：To investigate the effect of short-term continuous subcutaneous insulin infusion （CSII） treatment on islet β- cell function in newly diagnosed type 2 diabetic patients with different glycosylated hemoglobin （HbA1c）.Methods： According to the level of HbA1c （〈8.5%, 8.5%-10.0% and 〉10.0%）, 60 newly diagnosed type 2 diabetic patients were divided into 3 groups. All patients were treated with CSII for 2 weeks.Before and after the insulin treatment,their plasma insulin and plasma glucose at 0min, 1min, 2min, 4min, 6min, 10min were assessed by intravenous glucose tolerance test and Homa-β, Homa-IR, AUC0_10minINS（AUC： area under curve）were calculated.Results：Though there was no difference in 0min plasma insulin before and after the insulin treatment, there was significant difference at 1min,2min, 4 min, 6 min and 10min .The AUC0_10minINS increased apparently [ （93.6±82.7） μIU/ml vs（153.4±97.5）μIU/ml, P=0.000 before and after the treatment].Comparing the value difference before and after the treatment at each time point between the 3 groups, it was noticed that fasting plasma insulin in the group of HbA1c〉10.0% increased more remarkably than the other two groups. There was no difference at other time points on treatment effect between the 3 groups.Conclusion：In newly diagnosed type 2 diabetic patients with different HbA1c,short-term intensive insulin treatment at early time can improve islet β-cell function which was represented by the first-phase insulin secretion.

作者欧阳晓俊卞茸文何戎华

机构地区南京医科大学江苏省老年医学研究所糖尿病防治研究中心

出处《现代医药卫生》 2005年第20期2726-2728,共3页 Journal of Modern Medicine & Health

基金江苏省卫生厅重大课题资助(H200213)

关键词胰岛素强化治疗 2型糖尿病 Β细胞功能 Insulin intensive treatment Diabetes mellitus, type 2 Beta cell function

分类号 R5 [医药卫生—内科学]

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1祝方,纪立农,韩学尧,朱宇,张红杰,周翔海,陈静,蔡晓陵,张明霞.短期胰岛素强化治疗诱导初诊2型糖尿病患者血糖长期良好控制的临床试验[J].中国糖尿病杂志,2003,11(1):5-9. 被引量：854
2翁建平,李延兵,许雯,陈小华,廖志红,姚斌,邓婉萍,欧香忠,胡国亮.短期持续胰岛素输注治疗对初诊2型糖尿病患者胰岛β细胞功能的影响[J].中国糖尿病杂志,2003,11(1):10-15. 被引量：780
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