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目的:观察初诊2型糖尿病(T2DM)患者在胰岛素强化治疗过程中C肽(FC-P)的动态演变及其与强化治疗时间、降糖速度之间的关系,探讨葡萄糖毒性演变的规律,指导临床治疗。方法:对7例新诊断的T2DM患者胰岛素强化控制血糖12周,监测强化控制前、强化控制后1周、2周、4周、6周、8周、10周、12周的空腹血糖(FBG)和FC-P,患者入组后次日及第12周随访结束时检测糖化血红蛋白(HbA1c)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL)、高密度脂蛋白胆固醇(HDL),以FBG≤7.0mmol/L,餐后2h血糖(PBG)≤10mmol/L为治疗达标。结果:患者在接受胰岛素强化治疗过程中FBG逐渐接近达标后,FC-P仍处于动态演变过程。结论:胰岛素强化治疗能改善葡萄糖毒性。葡萄糖毒性改善的过程与强化降糖治疗的时间、降糖速度有一定关系。
OBJECTIVE: To observe the dynamic evolution of C-peptide (FC-P) in patients with newly diagnosed type 2 diabetes mellitus (T2DM) during intensive insulin therapy and its relationship with the duration of intensive treatment and the rate of hypoglycemic effect, and to explore the rules and guidance of the evolution of glucose toxicity Clinical treatment. Methods: Insulin in 7 newly diagnosed T2DM patients was intensively controlled for 12 weeks. The levels of fasting blood glucose (FBG) before intensive control, 1 week, 2 weeks, 4 weeks, 6 weeks, 8 weeks, 10 weeks and 12 weeks after intensive control were monitored. ), FC-P, HbA1c, triglyceride, total cholesterol, low density lipoprotein cholesterol (LDL), high density Lipoprotein cholesterol (HDL) to FBG ≤ 7.0mmol / L, 2h postprandial blood glucose (PBG) ≤ 10mmol / L for the treatment of compliance. Results: After FBG gradually approached the standard during intensive insulin therapy, FC-P was still in a dynamic evolution. Conclusion: Intensive insulin therapy can improve glucose toxicity. The process of glucose toxicity improvement and intensive hypoglycemic treatment time, hypoglycemic rate has a certain relationship.