摘要
目的探讨胰岛素泵强化治疗对新诊断2型糖尿病(T2DM)患者血糖控制及胰岛β细胞功能的影响。方法回顾性分析2012年2月至2016年2月建湖县人民医院内分泌科收治的102例新诊断T2DM患者的临床资料,按照治疗方法不同分为观察组(n=52)和对照组(n=50)。两组患者均先给予系统的糖尿病教育,制订个体化的饮食及适当的运动方案,并要求患者严格执行。在此基础上,对照组采用胰岛素笔2～3次餐前皮下注射门冬胰岛素30治疗,观察组采用胰岛素泵持续皮下输注门冬胰岛素治疗。观察两组患者治疗前和治疗后2周的空腹血糖(FBG)、餐后2 h血糖(2 h PG)、高敏C反应蛋白(hs-CRP)、果糖胺、胰岛β细胞功能以及血糖达标时间。结果治疗后,观察组患者FBG、2 h PG、hs-CRP及果糖胺低于对照组[(6. 18±1. 24) mmol/L比(8. 22±2. 39) mmol/L、(10. 68±2. 41) mmol/L比(12. 29±1. 23) mmol/L、(2. 16±0. 67) mg/L比(4. 06±0. 37) mg/L、(2. 54±0. 51) mmol/L比(2. 90±0. 62) mmol/L](P <0. 05)。观察组血糖达标时间短于对照组[(8. 56±0. 79) d比(12. 09±3. 43) d](P <0. 01)。治疗后,观察组患者空腹C肽、餐后C肽、稳态模型评估的β高于对照组[(0. 59±0. 12) nmol/L比(0. 51±0. 11) nmol/L、(2. 87±0. 63) nmol/L比(2. 38±0. 97) nmol/L、56. 34±30. 16比43. 78±31. 92](P <0. 05),稳态模型评估的胰岛素抵抗指数低于对照组(1. 01±0. 16比1. 32±0. 56)(P <0. 05)。结论胰岛素泵强化治疗可改善新诊断T2DM患者胰岛β细胞功能,同时使血糖平稳及更快达标。
Objective To investigate the effect of intensive insulin pump therapy on bood glucose and the function of isletβcell of patients with newly diagnosed type2diabetes mellitus(T2DM).Methods The data of102newly diagnosed patients with type2diabetes admitted to the Endocrinology Department of Jianhu People′s Hospital from Feb.2012to Feb.2016were retrospective analyzed.According to the treatment method,the patients were divided into an observation group(n=52)and a control group(n=50).Both groups were firstly given systemic diabetes education,individualized diets and appropriate exercise programs,and the control group received insulin pen subcutaneous2-3times of insulin aspart30before meal,while the observation group was treated with insulin pump continuous subcutaneous infusion of insulin aspart.Before and after two weeks treatment,the fasting blood glucose(FBG),two hours postprandial blood glucose(2h PG),high-sensitivity C-reactive protein(hs-CRP),fructosamine,isletβcell function and reaching standard time of blood glucose of two groups were observed.Results After treatment,FBG,2h PG,hs-CRP and fructosamine in the observation group were lower than those in the control group[(6.18±1.24)mmol/L vs(8.22±2.39)mmol/L,(10.68±2.41)mmol/L vs(12.29±1.23)mmol/L,(2.16±0.67)mg/L vs(4.06±0.37)mg/L,(2.54±0.51)mmol/L vs(2.90±0.62)mmol/L](P<0.05).The blood glucose standard reaching time in the observation group was shorter than that in the control group[(8.56±0.79)d vs(12.09±3.43)d](P<0.01).After treatment,the fasting C-peptide and postprandial C-peptide,homeostasis model assessment-βin the observation group were significantly higher than those in the control group[(0.59±1.12)nmol/L vs(0.51±0.11)nmol/L,(2.87±0.63)nmol/L vs(2.38±0.97)nmol/L,56.34±30.16vs43.78±31.92](P<0.05),homeostasis model assessment of insulin resistance was lower than that in the control group(1.01±0.16vs1.32±0.56)(P<0.05).Conclusion Intensive insulin pump treatment for newly diagnosed patients with T2DM improves their isletβcell function,making blood glucose stable and faster to reach the standard.
作者
何殿
高银婷
姜东芹
HE Dian;GAO Yinting;JIANG Dongqin(Department of Endocrinology,Jianhu County People′s Hospital ,Jianhu 224700,China)
出处
《医学综述》
2018年第23期4768-4772,共5页
Medical Recapitulate
关键词
新诊断2型糖尿病
胰岛素泵强化治疗
胰岛Β细胞功能
Newly diagnosed type 2 diabetes mellitus
Intensive insulin pump treatment
Isletβcell function
