摘要
目的探讨短期不同干预治疗对新诊断2型糖尿病患者的胰岛β细胞功能和长期血糖控制的影响。方法新诊断的2型糖尿病患者22例,随机分为单纯饮食运动治疗(对照组)5例、胰岛素泵治疗组(CSII组)6例、胰岛素多次注射治疗组(MDI组)5例及口服降糖药治疗组(OHA组)6例。短期治疗2周,采用自身前后对照,观察胰岛β细胞功能的变化及其影响因素,随访短期强化血糖控制治疗对长期血糖控制的影响。结果与对照组比较,CSII组、MDI组和OHA组治疗前后静脉葡萄糖试验中葡萄糖曲线下面积、胰岛素抵抗指数明显下降,胰岛素第1时相分泌功能、β细胞功能指数明显升高(P<0.05)。2例CSII组患者仅采用饮食控制(1例1年,1例2年)、1例MDI组患者2年未使用任何降糖药物即可控制血糖。结论短期强化血糖控制可以显著改善胰岛β细胞功能,减轻胰岛素抵抗,使患者回到2型糖尿病自然病程的更早期阶段。强化胰岛素治疗组得到的缓解时间比OHA组更长。
Objective To study the effects of different short-term intervenient treatments on β cell function and long-term glycemic control in newly diagnosed type 2 diabetic patients. Methods Twenty- two newly diagnosed type 2 diabetic patients were randomized into four groups： control group （n= 5） were treated by diet and exercise therapy, CSII group （n = 6） with insulin pump therapy; MDI group （n= 5） with multiple daily insulin injection, OHA group （n=6） with oral hypoglycemic agent. The patients were treated for 2 weeks and their β-cell function was assessed by the intravenous glucose tolerance test and compared between before and after the treatment. After the treatment, all patients were followed up for their glycemic level control. Results Two weeks after the treatment, the mean area under the curve （AUC） of glucose and Homa-IR decreased obviously （P〈O. 05）, acute insulin response （AIR0-10） and Homa-β also improved （P 〈0.05） significantly in the groups of CSII, MDI and OHA, when compared with the control. In CSII group, one patient was followed up for 1 year and showed excellent glycemic control without any medication, except diet therapy , so was for 2 years in another one. The same result was found for one patient in MDI group for 1 year follow up. Oonclusion No matter which treatment, short-term intensive plasma glucose reduction could improve β-cell function, relieve insulin resistance, and the patients could be brought back to the early stage of of type 2 diabetes. The result of intensive insulin therapy was better than that of oral hypoglycemic agent therapy.
出处
《福建医科大学学报》
2008年第5期425-428,共4页
Journal of Fujian Medical University
关键词
糖尿病
2型
胰岛
胰岛素
血糖
临床对照试验
治疗结果
diabetes mellitus, type 2
islets of langerhans
insulin
blood glucose
controlled clinical trials
treatment outcome
