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目的:观察胰岛素泵连续皮下输注(CSII)和多次皮下注射治疗(MSII)对伴明显高血糖的初诊2型糖尿病患者胰岛β细胞功能的影响。方法:新诊断的伴明显高血糖的2型糖尿病患者(空腹血糖>12 mmol/L和/或2 h血糖>14 mmol/L)30例,分别予以2周的CSII和MSII,检测治疗前后患者的空腹和餐后2 h血糖、胰岛素水平以及静脉葡萄糖耐量(IVGTT)试验的胰岛素分泌,得出IVGTT中血浆胰岛素的峰值(AIR)、β细胞功能(Homaβ)和胰岛素抵抗(Homa IR),评价胰岛β细胞功能的变化。结果:CSII组治疗前后AIR、Homaβ有显著性差异(P<0.01),Homa IR无显著性差异(P>0.05);MSII组治疗前后AIR、Homaβ和Homa IR均无显著性差异(P>0.05);两组治疗前空腹和餐后2 h血糖、胰岛素水平、AIR、Homaβ和Homa IR均无显著性差异(P>0.05);治疗后AIR和Homaβ有显著性差异(P<0.01),Homa IR无显著性差异(P>0.05)。结论:CSII强化治疗能显著改善伴明显高血糖的初诊2型糖尿病患者的胰岛β细胞功能。
Objective: To observe the effects of continuous subcutaneous infusion of insulin pump (CSII) and multiple subcutaneous injections (MSII) on islet β-cell function in newly diagnosed type 2 diabetic patients with obvious hyperglycemia. Methods: Thirty newly diagnosed type 2 diabetic patients with hyperglycemia (fasting blood glucose> 12 mmol / L and / or 2 h blood glucose> 14 mmol / L) were given CSII and MSII for 2 weeks respectively. The fasting and postprandial 2-h glucose, insulin levels and IVGTT insulin secretion were measured to obtain AIR, Homaβ, and Homa IR in IVGTT, Islet β-cell function changes. Results: Before and after treatment, the levels of AIR and Homaβ in CSII group were significantly different (P <0.01), but there was no significant difference in Homa IR (P> 0.05). There was no significant difference in AIR, Homaβ and Homa IR before and after treatment in CSII group ); There was no significant difference in fasting blood glucose, insulin level, AIR, Homaβand Homa IR between the two groups before treatment and 2h after treatment (P> 0.05); Homa IR no significant difference (P> 0.05). CONCLUSIONS: Intensive CSII treatment significantly improves pancreatic β-cell function in newly diagnosed type 2 diabetic patients with marked hyperglycemia.