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目的比较不同的治疗方法对初发2型糖尿病患者胰岛B细胞功能的影响。方法将200例新诊断的初发2型糖尿病患者随机分为胰岛素组、格列美脲组、瑞格列奈组、二甲双胍组和噻唑烷二酮组,在饮食及运动治疗的基础上,比较不同方法治疗前后的降糖效果和对胰岛B细胞功能的改善作用。结果胰岛素组使胰岛素早期分泌水平明显上升,瑞格列奈组使胰岛素早期分泌水平也上升,且明显高于其他三种降糖药,而对于胰岛素总体分泌量影响很小。格列美脲对胰岛素早期分泌影响甚微,但对于胰岛素第二时相分泌的效应是最强的,它使负荷胰岛素分泌值缓慢上升,高峰值靠后。噻唑烷二酮也可以提高胰岛素早期分泌水平,说明胰岛素分泌早期时相恢复。二甲双胍也可使胰岛素早期分泌水平上升。结论2型糖尿病患者早期口服降糖药严格控制血糖,可以使胰岛功能有所改善,特别是瑞格列奈;但早期使用胰岛素严格控制血糖比口服降糖药更有利于胰岛B细胞分泌早期时相的恢复。
Objective To compare the effects of different treatment methods on the function of islet B cells in newly diagnosed type 2 diabetic patients. Methods 200 newly diagnosed newly diagnosed type 2 diabetic patients were randomly divided into insulin group, glimepiride group, repaglinide group, metformin group and thiazolidinedione group, on the basis of diet and exercise therapy, compared Hypoglycemic effect of different methods before and after treatment and on the function of islet B cells to improve. Results Insulin group significantly increased the level of early insulin secretion, repaglinide group also increased the level of early insulin secretion, and was significantly higher than the other three hypoglycemic agents, but little effect on the overall insulin secretion. Glimepiride had little effect on the early insulin secretion, but the second phase insulin secretion effect is the strongest, it makes the load of insulin secretion increased slowly, the peak value of the latter. Thiazolidinediones can also increase the level of early insulin secretion, indicating the early recovery of insulin secretion. Metformin also increases early insulin secretion. Conclusion Early oral administration of hypoglycemic agents in type 2 diabetic patients strictly controls blood glucose, which can improve the function of islets, especially repaglinide. But the early use of insulin to control blood glucose is more beneficial than the oral hypoglycemic agents in the early secretion of pancreatic B cells Phase recovery.