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目的观察不同病程初诊2型糖尿病对胰岛素短期强化治疗的效果,分析治疗前后胰岛β细胞功能改善及胰岛素抵抗的变化。方法选取59例初诊2型糖尿病患者为研究对象,按照病程不同分为A组(23例,病程短于3个月)和B组(36例,病程3个月~5年),两组患者均给予“三短一长”的胰岛素强化治疗,4周后比较两组患者的血糖、糖化血红蛋白、胰岛素抵抗指数(HOMA-IR)及胰岛素分泌指数(HOMA-β)等指标的变化。结果两组患者4周胰岛素强化治疗结束后,FBG、Hb1Ac和TG均较治疗前有显著改善(P<0.05),A、B组间比较差异无统计学意义(P>0.05)。但B组胰岛素用量及血糖平均达标时间均高于A组(P<0.05)。治疗结束后两组患者HOMA-IR显著升高,HOMA-β降低(P<0.05),但A组患者HOMA-IR、HOMA-β改善程度优于B组。结论胰岛素短期强化治疗对不同病程2型糖尿病均有效果,但胰腺分泌功能及胰岛素抵抗的改善程度随病程延长而下降。
Objective To observe the effect of newly diagnosed type 2 diabetes mellitus patients with different disease course on insulin short-term intensive therapy and to analyze the changes of pancreatic β-cell function and insulin resistance before and after treatment. Methods Fifty-nine patients with newly diagnosed type 2 diabetes mellitus were enrolled in this study. Patients were divided into group A (23 patients with shorter duration of 3 months) and group B (36 patients, duration 3 months to 5 years) All patients were given “three short and one long” intensive insulin therapy. The changes of blood glucose, glycosylated hemoglobin, insulin resistance index (HOMA-IR) and insulin secretion index (HOMA-β) were compared between the two groups after 4 weeks. Results After 4 weeks of intensive insulin treatment, FBG, Hb1Ac and TG were significantly improved in both groups (P <0.05). There was no significant difference between groups A and B (P> 0.05). However, the amount of insulin in group B and the mean time to blood glucose were higher than those in group A (P <0.05). After treatment, HOMA-IR and HOMA-β in both groups were significantly decreased (P <0.05), but the improvement of HOMA-IR and HOMA-β in group A was better than that in group B. Conclusion Insulin short-term intensive treatment has different effects on type 2 diabetes mellitus, but the degree of improvement of pancreatic secretion and insulin resistance decreases with the prolongation of the course of the disease.