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目的观察新诊断2型糖尿病患者短期胰岛素泵强化治疗后空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(Hb A1c)、血清C肽水平及胰岛素抵抗改善情况。方法 62例新诊断2型糖尿病患者,均给予2周的胰岛素泵强化治疗,比较患者治疗前后空腹血糖、餐后2 h血糖、Hb A1c、血清C肽,计算胰岛B细胞功能指数(HOMA-B)、胰岛素抵抗指数(HOMA-IR)。结果 62例患者经胰岛素泵强化治疗达标所需时间为(4.7±0.9)d,平均胰岛素用量为(38.4±5.2)U/d,治疗2周后,患者FPG、2 h PG水平、HOMA-IR指数均较治疗前明显下降,差异有统计学意义(P<0.01);患者Hb A1c均较治疗前有所下降,但差异无统计学意义(P>0.05);患者血清C肽水平、HOMA-B较治疗前升高,差异有统计学意义(P<0.01)。结论新诊断2型糖尿病给予2周的胰岛素泵强化治疗后可以早期解除糖毒性,胰岛B细胞功能明显优于治疗前,胰岛素抵抗得到改善,是首选有效的治疗方法 ,值得临床推广应用。
Objective To observe the improvement of fasting blood glucose (FPG), 2 h postprandial blood glucose (2 h PG), Hb A1c, serum C-peptide and insulin resistance in patients with newly diagnosed type 2 diabetes mellitus after intensive insulin treatment. Methods Sixty-two newly diagnosed type 2 diabetic patients were given insulin pump for two weeks. Fasting blood glucose, postprandial blood glucose, Hb A1c, serum C-peptide and HOMA-B ), Insulin resistance index (HOMA-IR). Results The duration of intensive insulin therapy in 62 patients was (4.7 ± 0.9) d and the average amount of insulin was (38.4 ± 5.2) U / d. After 2 weeks of treatment, FPG, 2 h PG level, HOMA-IR (P <0.01). The Hb A1c in patients was lower than that before treatment, but the difference was not statistically significant (P> 0.05). The levels of serum C-peptide, HOMA- B was higher than before treatment, the difference was statistically significant (P <0.01). Conclusions The newly diagnosed type 2 diabetes mellitus after 2 weeks of intensive insulin treatment can relieve the early toxication. The function of pancreatic islet B cells is obviously better than that before treatment, and the insulin resistance is improved. It is the first choice and effective treatment, which is worthy of clinical application.