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目的:探讨不同治疗方式对初诊2型糖尿病血糖控制情况及胰岛素B细胞功能的影响。方法:采取不同治疗方式,选择FBG7.0～16.7mmol/L的2型糖尿病患者,在饮食控制、运动的基础上随机分为胰岛素组、口服药治疗组及对照组,其中胰岛素治疗组随机分为胰岛素强化治疗组及预混胰岛素二次治疗组,治疗前后查OGTT、内生胰岛功能及HbA1c,1～3个月复查1次,随诊1年。结果:强化治疗组与预混胰岛素二次治疗组血糖分别于治疗后(5.9±1.3)、(9.6±2.1)d达到良好控制,达标所需时间均显著低于对照组的(21.6±7.9)d(均P<0.05)。强化治疗组治疗3个月后复查HbA1c,降低程度显著优于口服降糖药组及对照组(均P<0.05);而胰岛素组及口服降糖药组内生胰岛测定由治疗前的(37.3±27.8)、(38.2±28.2)U/ml提高到治疗后的(54.4±31.6)、(40.1±28.3)U/ml。结论:初诊2型糖尿病患者短期应用胰岛素或口服药治疗,强化血糖控制均可改变胰岛B细胞功能,并可诱导部分患者长达1年的血糖控制,胰岛素治疗在降低血糖幅度方面明显优于其他治疗方式,故可考虑根据患者具体情况采用多种强化治疗方式。
Objective: To investigate the effects of different treatment methods on blood glucose control and insulin B cell function in newly diagnosed type 2 diabetic patients. Methods: The patients with type 2 diabetes mellitus (FBG7.0 ~ 16.7mmol / L) were randomly divided into insulin group, oral drug treatment group and control group on the basis of diet control and exercise. The patients in the insulin treatment group were randomly assigned For the insulin-intensive treatment group and pre-mixed insulin secondary treatment group before and after treatment check OGTT, endogenous islet function and HbA1c, 1 to 3 months to review 1, followed up for 1 year. Results: The blood glucose of the intensive treatment group and the premixed insulin secondary treatment group were well controlled after treatment (5.9 ± 1.3) and (9.6 ± 2.1) d, respectively, and the time required for compliance was significantly lower than that of the control group (21.6 ± 7.9) d (all P <0.05). The level of HbA1c was significantly lower in the intensive treatment group than in the oral hypoglycemic group and the control group (all P <0.05). The endogenous insulin levels in the insulin group and the oral hypoglycemic group were significantly lower than those before the treatment (37.3 ± 27.8), (38.2 ± 28.2) U / ml to (54.4 ± 31.6) and (40.1 ± 28.3) U / ml after treatment. Conclusion: Short-term treatment with insulin or oral drug in patients with newly diagnosed type 2 diabetes mellitus can improve the function of islet B cells and enhance the blood glucose control in some patients for up to 1 year. Intensive insulin therapy is superior to others in reducing blood glucose level Treatment, it can be considered according to the specific circumstances of patients with a variety of intensive treatment.