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目的:探讨甘精胰岛素对门诊初诊的2型糖尿病(type 2 diabetes mellitus,T2DM)患者糖脂代谢、胰岛B细胞功能、胰岛素测定的影响。方法:32例初诊T2DM患者,给予甘精胰岛素每晚定时皮下注射1次,剂量为0.2～1.0 U/(kg.d),治疗3个月后观察体重、血糖、血脂、血压、胰岛素抵抗指数、胰岛素分泌指数的变化。结果:3个月后患者血糖、血脂、血压、糖化血红蛋白(HbA1c)均显著降低,差异有统计学意义(P<0.05);治疗前后体重没有明显变化,甘精胰岛素使用后,胰岛素分泌曲线较前上升,且口服葡萄糖耐量试验(OGTT)后呈典型的胰岛素分泌曲线,即治疗后胰岛素分泌指数显著增加,胰岛素抵抗指数显著改善,胰岛素早期相分泌前移,差异均有统计学意义(P<0.05或P<0.01),且治疗后胰岛素分泌曲线及高峰与C-肽一致。结论:甘精胰岛素短期内可有效改善患者的血糖、血脂、血压水平及胰岛细胞分泌功能,且不影响糖耐量试验下胰岛素分泌的检测,提示血浆检测胰岛素与甘精胰岛素具有不同的免疫原性。
Objective: To investigate the effects of insulin glargine on glucose and lipid metabolism, islet B cell function and insulin in type 2 diabetes mellitus patients newly diagnosed in outpatients. Methods: Thirty-two newly diagnosed T2DM patients were given insulin glargine subcutaneously once a night at a dose of 0.2-1.0 U / (kg · d) for 3 months. The body weight, blood glucose, blood lipid, blood pressure, insulin resistance index , Changes in insulin secretion index. Results: After 3 months, the blood glucose, blood lipid, blood pressure and HbA1c were significantly decreased (P <0.05). There was no significant change in body weight before and after treatment. After insulin glargine administration, the insulin secretion curve Before the oral glucose tolerance test (OGTT) showed a typical insulin secretion curve, that is, after treatment, significantly increased insulin secretion index, insulin resistance index improved significantly, early insulin secretion phase advance, the difference was statistically significant (P < 0.05 or P <0.01), and the insulin secretion curve and peak were consistent with C-peptide after treatment. CONCLUSION: Insulin glargine can effectively improve the blood glucose, blood lipid, blood pressure and insulin secretion in short term, and does not affect the insulin secretion test in glucose tolerance test, suggesting that plasma insulin and glargine insulin have different immunogenicity .