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目的探讨甘精胰岛素、胰岛素泵持续皮下输注对初诊2型糖尿病患者的疗效。方法选择2007年1月至2010年3月180例初诊的2型糖尿病患者,随机分为3组,分别采用甘精胰岛素(A组)、胰岛素泵(B组)及常规口服降糖药物(C组)进行12周的治疗,检测治疗前后血糖、糖化血红蛋白(HbA1c)、胰岛素、C肽水平,计算β细胞功能(Homa-β)、胰岛素抵抗指数(Homa-IR)、血糖曲线下面积(AUCg)、胰岛素曲线下面积(AUCi),比较各项指标的变化。结果 3组患者治疗后血糖、HbA1c、Homa-IR、AUCg均较治疗前降低,胰岛素、C肽、Homa-β及AUCi均较治疗前升高,有显著性差异(P<0.01)。其中A组治疗前后HbA1c为(10.89±2.42)vs.(6.15±1.24),B组(11.42±2.31)vs.(6.23±1.29),C组(11.37±2.50)vs.(7.15±1.39);而A组治疗前后空腹胰岛素(7.14±1.24)μIU/mlvs.(10.03±1.67)μIU/ml,B组(7.20±1.42)μIU/mlvs.(10.34±1.65)μIU/ml,C组(7.01±1.38)μIU/mlvs.(8.94±1.51)μIU/ml。A、B组较C组改变更显著(P<0.05),A、B组间无显著性差异。结论甘精胰岛素和胰岛素泵持续皮下输注均能明显改善初诊2型糖尿病患者的胰岛β细胞功能。
Objective To investigate the efficacy of continuous insulin infusion of insulin glargine and insulin pump on newly diagnosed type 2 diabetic patients. Methods 180 cases of newly diagnosed type 2 diabetic patients from January 2007 to March 2010 were randomly divided into 3 groups: insulin-glargine group A, insulin pump group B and conventional oral hypoglycemic agents C (HbA1c), insulin and C-peptide levels were calculated before and after treatment. Homa-β, Homa-IR, area under the curve of blood glucose (AUCg ), The area under the curve of insulin (AUCi), compare the changes of each index. Results The blood glucose, HbA1c, Homa-IR and AUCg of three groups were lower than those before treatment. The levels of insulin, C-peptide, Homa-β and AUCi in the three groups were significantly higher than those before treatment (P <0.01). HbA1c was (10.89 ± 2.42) vs. (6.15 ± 1.24), B (11.42 ± 2.31) vs. (6.23 ± 1.29), C (11.37 ± 2.50) vs. (7.15 ± 1.39) in group A, The fasting insulin (7.14 ± 1.24) μIU / ml vs (10.03 ± 1.67) μIU / ml, B group (7.20 ± 1.42) μIU / ml vs (10.34 ± 1.65) μIU / ml in group A before treatment and 7.01 ± 1.38) μIU / ml vs. (8.94 ± 1.51) μIU / ml. The changes in group A and B were more significant than those in group C (P <0.05). There was no significant difference between group A and group B. Conclusion Both glargine and insulin pump sustained subcutaneous infusion can significantly improve pancreatic β-cell function in newly diagnosed type 2 diabetic patients.