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[目的]探讨短期胰岛素强化治疗对初诊2型糖尿病患者(T2DM)胰岛β细胞功能的影响。[方法]初诊2型糖尿病患者80例,随机分为胰岛素组(治疗组)和口服降糖药物组(对照组),各40例。治疗组胰岛素泵进行短期胰岛素强化治疗1周后改为胰岛素(优泌林预混70/30)皮下注射,对照组口服药物治疗,12周后观察两组糖脂代谢情况及胰岛功能。[结果]两组治疗前后体质量指数(BMI)无明显差别(P﹤0.05),两组治疗后空腹血糖(FBG)、餐后2h血糖(2hBG)、甘油三酯(TG)及糖化血红蛋白(HbA1C)明显下降,与治疗前比较差异有统计学意义(P﹤0.05);治疗组治疗后HbA1C、HOMA-IR下降、胰岛素(INS)、HOMAβ明显上升,与对照组比较差异有统计学意义(P﹤0.05);治疗组缓解率45%,对照组缓解率5%,两组比较差异有统计学意义(P﹤0.05)。[结论]初诊2型糖尿病患者早期胰岛素治疗能更早更有效地控制血糖水平,并能使胰岛β细胞功能得到改善。
[Objective] To investigate the effect of short-term intensive insulin therapy on pancreatic β-cell function in newly diagnosed type 2 diabetic patients (T2DM). [Methods] 80 newly diagnosed type 2 diabetic patients were randomly divided into insulin group (treatment group) and oral hypoglycemic drug group (control group), 40 in each. One week after treatment, the insulin pump in the treatment group was subcutaneously injected with insulin (Eucomin premixed 70/30), and the control group was treated with oral medication. After 12 weeks, the glucose and lipid metabolism and islet function were observed in two groups. [Results] There was no significant difference in body mass index (BMI) between the two groups before and after treatment (P <0.05). After treatment, fasting blood glucose (FBG), postprandial 2h blood glucose (2hBG), triglyceride (TG) and glycosylated hemoglobin (P <0.05). The HbA1C and HOMA-IR decreased, but the levels of INS and HOMAβ in the treatment group increased significantly compared with those in the control group (P <0.05). The difference was statistically significant (P < P <0.05). The response rate was 45% in the treatment group and 5% in the control group. There was significant difference between the two groups (P <0.05). [Conclusion] Early insulin treatment in newly diagnosed type 2 diabetic patients can control blood glucose level earlier and more effectively, and can improve the function of islet β cells.