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目的观察短期胰岛素泵强化治疗对不同病程T2DM患者胰岛功能改善的影响。方法选择不同病程T2DM患者72例,胰岛素泵强化治疗2周。治疗前后行75gOGTT检测血糖、胰岛素及C-P,计算胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)及胰岛素早时相分泌功能指数(ΔI30/ΔG30)。结果强化治疗后各组HOMA-IR差异均有统计学意义(P<0.05)。新诊断T2DM患者(A组)和病程1～5年T2DM患者(B组)治疗前后HOMA-β及ΔI30/ΔG30较治疗前升高,差异有统计学意义(P<0.05)。病程5～10年T2DM患者(C组)HOMA-β较治疗前升高,但差异无统计学意义。结论病程较短的T2DM患者早期使用胰岛素泵强化治疗可改善胰岛功能,包括分泌功能和IR。对于病程长的患者,强化治疗虽不能改善胰岛分泌功能,但理想控制血糖可减轻IR。
Objective To observe the effect of short-term insulin pump intensive therapy on pancreatic function in T2DM patients with different course of disease. Methods 72 patients with T2DM with different course of disease were selected, and insulin pump was intensively treated for 2 weeks. Blood glucose, insulin and C-P were measured before and after treatment with 75gOGTT. The indexes of HOMA-β, HOMA-IR and ΔI30 / ΔG30 were calculated. Results HOMA-IR differences in each group after intensive treatment were statistically significant (P <0.05). The levels of HOMA-β and ΔI30 / ΔG30 in newly diagnosed T2DM patients (group A) and T2DM patients (group B) with 1-5 years of disease duration were significantly higher than those before treatment (P0.05). HOMA-β in T2DM patients (group C) with a duration of 5-10 years was higher than that before treatment, but the difference was not statistically significant. Conclusion Early treatment of insulin pump in T2DM patients with shorter duration may improve pancreatic islet function, including secretory function and IR. For patients with longer duration, intensive treatment although not improve pancreatic secretion, but the ideal control of blood glucose can reduce IR.