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目的:讨论早期使用胰岛素泵持续皮下输注胰岛素(CSII)强化治疗初诊2型糖尿病患者的降糖效果。方法:对30例空腹血糖≥11.1mmol/L的初诊2-DM患者进行为期2周的CSII强化治疗,于治疗前后定期测定空腹血糖(FPG)、餐后2h血糖(2hPG),进行静脉葡萄糖耐量试验(IGTT),观察胰岛素分泌第一时相,计算胰岛素及C肽曲线下面积(AUC),计算胰岛β细胞功能指数(Homaβ)和胰岛素抵抗指数(Homa IR)。结果:2周的CSII强化治疗后,30例患者FPG、2hPG明显下降(P<0.01),并在治疗第5.3±2.6天达到血糖控制标准。多数患者在IGTT中恢复了不同程度的胰岛素第一时相分泌,患者IGTT时胰岛素、C肽曲线下面积和Homaβ明显提高,Homa IR则明显下降(P<0.01)。结论:对伴明显高血糖的初诊2-DM患者,短期CSII强化治疗具有快速稳定控制血糖和显著改善胰岛β细胞功能的作用,并能改善胰岛素抵抗。
OBJECTIVE: To discuss the hypoglycemic effect of early adoptive insulin pump (CSII) intensive treatment of newly diagnosed type 2 diabetic patients. Methods: Thirty patients with newly diagnosed 2-DM with fasting blood glucose≥11.1mmol / L were treated with CSII for 2 weeks. Fasting blood glucose (FPG) and 2h postprandial glucose (2hPG) were measured before and after treatment. Venous glucose tolerance (IGTT), observed the first phase of insulin secretion, calculated the area under the curve of insulin and C-peptide (AUC) and calculated the Homaβ and Homa IR. Results: After 2 weeks of intensive CSII treatment, the FPG and 2hPG levels of 30 patients were significantly decreased (P <0.01), and reached the blood glucose control standard of 5.3 ± 2.6 days after treatment. In IGTT, most patients recovered different levels of first-phase insulin secretion. The area under the curve of insulin, C-peptide and Homaβ in patients with IGTT were significantly decreased, while Homa IR was significantly decreased (P <0.01). CONCLUSIONS: Short-term CSII intensive treatment of newly diagnosed 2-DM patients with significant hyperglycemia has the effect of controlling blood glucose rapidly and stably and significantly improving pancreatic β-cell function, and can improve insulin resistance.