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目的探讨初诊2型糖尿病患者标准馒头餐后2小时C肽与空腹C肽比值(C2/C0)的临床意义。方法初诊T2DM患者87例,分为Ⅰ组(C2/C0≥3,n=43)和Ⅱ组(C2/C0<3,n=44)。经2～3周的胰岛素泵强化治疗,3个月后随访,比较两组间的降糖方案和血糖控制情况。结果胰岛素泵强化治疗后空腹及餐后血糖控制良好。随访时胰岛素抵抗指数无显著差异(2.48±0.89vs.2.31±1.54,P>0.05);胰岛素分泌指数显著上升(147.2±58.4vs.25.8±23.6,P<0.01)。Ⅰ组比Ⅱ组有更多的患者可采用单独生活方式干预控制血糖良好(20/43vs.5/44,P<0.05);Ⅱ组比Ⅰ组有更多的患者需胰岛素(≥20U/d)控制血糖(21/44vs.9/43,P<0.05);需用口服降糖药者两组间在病例数上无显著差别(14/43vs.18/44,P>0.05),但Ⅰ组患者比Ⅱ组患者需要的降糖药物更少。结论初诊2型糖尿病患者的C2/C0比值,可用于评价患者β细胞功能,指导治疗方案的选择。
Objective To investigate the clinical significance of 2-hour postprandial C-peptide and C-peptide ratio (C2 / C0) in patients with newly diagnosed type 2 diabetes mellitus. Methods 87 patients with newly diagnosed T2DM were divided into group Ⅰ (C2 / C0≥3, n = 43) and group Ⅱ (C2 / C0 <3, n = 44). After 2 to 3 weeks of insulin pump intensive treatment, follow-up after 3 months to compare the two groups of hypoglycemic regimen and glycemic control. Results Fasting and postprandial glycemic control were better after intensive insulin treatment. Insulin resistance index had no significant difference at follow up (2.48 ± 0.89 vs.2.31 ± 1.54, P> 0.05). Insulin secretion index increased significantly (147.2 ± 58.4 vs.25.8 ± 23.6, P <0.01). More patients in group Ⅰ than those in group Ⅱ had better control of blood glucose (20/43 vs.5 / 44, P <0.05), while those in group Ⅱ had more insulin (≥20U / d (21/44 vs. 9/43, P <0.05). There was no significant difference in the number of cases between the two groups (14/43 vs.18 / 44, P> 0.05) Patients in group had fewer hypoglycemic agents than patients in group II. Conclusions The C2 / C0 ratio of newly diagnosed type 2 diabetic patients can be used to evaluate the β cell function in patients and guide the choice of treatment options.