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目的观察胰岛素类似物短期强化治疗初诊2型糖尿病(T2DM)的疗效。方法将88例初诊T2DM患者随机分为胰岛素类似物多次皮下注射组(观察组)和胰岛素泵组(对照组),每组各44例,连续治疗ZW,分别于治疗前后测空腹血糖(FPG)、空腹胰岛素(FINS)、空腹C肽(FC-P)及进食100g标准淀粉馒头后2h血糖(2hPG)、2h胰岛素(2hINS),2hC肽(2hC-P),并分别计算HOMA-IR、HOMA-,记录血糖达标时间、达标日胰岛素类似物用量,低血糖发生频率。结果治疗后两组FINS、FC-P、2hINS、2Hc-P、HOMA-较治疗前明显升高(P<0.01)、FPG、2hPG、HOMA-IR明显下降(P<0.01);两组间比较,治疗前和治疗后FINS、FC-P、2Hc-P、HOMA-、FPG、2hPG、HOMA-IR无统计学差异(P>0.05),低血糖发生过频率无统计学差异(P>0.05),达标时间胰岛素泵组(2.46±0.78)d明显短于胰岛素类似物组(5.42±1.76)d(P<0.05),达标日胰岛素类似物用量胰岛素泵组(31.25±9.12)U/d,略少于胰岛素类似物皮下注射组(36.43±8.24U/d)但无统计学差异(P>0.05)。随访6个月,两组患者在饮食运动治疗下,多数血糖均控制良好,需药物治疗的比例无明显差别。结论胰岛素类似物短期强化治疗初诊T2DM能明显改善胰岛β细胞功能,降低胰岛素抵抗,使多数血糖较高的初诊T2DM患者在长期不服药的情况下,血糖得到良好控制,可取的胰岛素泵强化治疗相似的效果。
Objective To observe the efficacy of insulin analogue short-term intensive treatment of newly diagnosed type 2 diabetes mellitus (T2DM). Methods 88 cases of newly diagnosed T2DM patients were randomly divided into multiple subcutaneous injection of insulin analogues (observation group) and insulin pump group (control group), 44 cases in each group. ZW was continuously treated before and after treatment. Fasting blood glucose (FPG) Fasting insulin (FINS), fasting C-peptide (FC-P), and 2hPG, 2hINS and 2hC-P after 100g standard starch steamed bread were measured. HOMA-IR, HOMA-, record blood glucose compliance time, the standard insulin dosage, the frequency of hypoglycemia. Results The levels of FINS, FC-P, 2hINS, 2Hc-P and HOMA-1 in the two groups were significantly higher than those before treatment (P <0.01), but FPG, 2hPG and HOMA- (P> 0.05). There was no significant difference in the frequency of hypoglycemia (P> 0.05) between the two groups before and after treatment. There was no significant difference in FINS, FC-P, 2Hc-P, HOMA-, FPG, 2hPG and HOMA- (2.46 ± 0.78) d for the standard time was significantly shorter than that of the insulin analogue group (5.42 ± 1.76) d (P <0.05), and the standard insulin dosage for the insulin pump group (31.25 ± 9.12) U / d slightly Less than the insulin analog subcutaneous injection group (36.43 ± 8.24U / d) but no significant difference (P> 0.05). After 6 months of follow-up, two groups of patients under the diet exercise treatment, most of the blood sugar are well controlled, requiring no significant difference in the proportion of drug treatment. Conclusion Insulin analogue short-term intensive treatment of newly diagnosed T2DM can significantly improve pancreatic β-cell function and reduce insulin resistance, so that the majority of newly diagnosed T2DM patients with high blood sugar do not take medication for a long time, the blood sugar is well controlled and the desirable insulin pump intensive treatment is similar Effect.