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目的探讨初诊2型糖尿病(T2DM)患者短期胰岛素强化治疗后获长期缓解的影响因素。方法 42例初诊T2DM患者,经2周胰岛素强化治疗后,先给予饮食及运动干预,若血糖不达标,则加用口服降糖药物。追踪观察至少1年。结果 (1)与强化治疗前相比,强化治疗后以及1年后随访的FPG、曲线下葡萄糖面积、HOMA-IR明显降低,曲线下胰岛素面积、△I_(30)/△G_(30)明显增加(P<0.05或P<0.01)。(2)与需口服降糖药物治疗患者相比,单纯饮食控制患者胰岛素强化治疗后FPG、强化治疗停止时胰岛素用量均明显降低,而△I_(30)/AG_(30)则明显增高(P<0.05)。结论短期胰岛素强化治疗可改善糖尿病患者病理生理缺陷。以较低的胰岛素用量能良好控制血糖,β细胞功能得到较好恢复的初诊T2DM者将来获得病情缓解的可能性较大。
Objective To investigate the influencing factors of long-term remission of newly diagnosed type 2 diabetes mellitus (T2DM) patients after short-term intensive insulin therapy. Methods Forty-two newly diagnosed T2DM patients were given diet and exercise intervention after intensive insulin treatment for 2 weeks. If blood glucose did not reach the standard, oral hypoglycemic drugs were added. Follow up for at least 1 year. Results (1) Glucose area and HOMA-IR under the curve were significantly lower than those before intensive treatment and after one-year follow-up. The area of insulin under curve, △ I_ (30) / △ G_ (30) Increase (P <0.05 or P <0.01). (2) Compared with patients receiving oral hypoglycemic drugs, FPG in intensive diet control patients decreased significantly at the end of intensive therapy, while △ I_ (30) / AG_ (30) increased significantly (P <0.05). Conclusion Short-term intensive insulin therapy can improve the pathophysiology of diabetic patients. With a lower amount of insulin can control blood sugar, β-cell function is better to recover the newly diagnosed T2DM patients in the future to obtain a greater likelihood of remission.