早期胰岛素强化治疗对初发2型糖尿病胰岛B细胞功能的临床观察

郭芸 郝玺 张彩云

[摘要] 目的 分析對初发2型糖尿病患者采取早期胰岛素强化治疗，对患者胰岛B细胞功能的影响。方法 选入该院于2016年8月—2017年8月期间进行治疗的初发2型糖尿病患者60例，以抽签法的形式将其分为实验组和对照组，分别为30例。对照组行口服降糖药物治疗，实验组行胰岛素泵强化治疗，对比2组患者不同时间段血糖变化、C肽变化，血糖达标时间。结果 2组患者在治疗之前，血糖变化、C肽变化差异无统计学意义（P>0.05）;治疗1个月之后，实验组的血糖变化比对照组明显，且实验组的C肽水平高于对照组（P<0.05）;治疗3个月之后，2组患者血糖变化差异无统计学意义（P>0.05）;实验组的C肽水平比对照组高（P<0.05）;实验组血糖达标时间比对照组短（P<0.05）。 结论 对初发2型糖尿病患者，在早期进行胰岛素强化治疗，能够较好地控制血糖变化，解除高糖毒性，对胰岛B细胞功能起到较好的保护效果。

[关键词] 胰岛素;初发2型糖尿病;胰岛B细胞

[中图分类号] R4          [文献标识码] A          [文章编号] 1672-4062（2020）05（b）-0049-03

Clinical Observation of Early Intensive Insulin Therapy on Islet B Cell Function in Newly Diagnosed Type 2 Diabetic Patients

GUO Yun， HAO Xi， ZHANG Cai-yun

Department of Nephrology and Endocrinology， Tonghai County People's Hospital， Tonghai， Yunnan Province， 652700 China

[Abstract] Objective To analyze the effect of early intensive insulin therapy on patients with first-onset type 2 diabetes on the function of pancreatic islet B cells. Methods Sixty patients with type 2 diabetes who were treated in the hospital from August 2016 to August 2017 were enrolled， and they were divided into experimental group and control group， with 30 cases in each group. The control group was treated with oral hypoglycemic drugs， and the experimental group was treated with intensive insulin pump therapy. The blood glucose changes， C-peptide changes， and blood glucose compliance time of the two groups were compared. Results There was no statistically significant difference in blood glucose and C-peptide changes between the two groups of patients before treatment（P>0.05）; after one month of treatment， the blood glucose changes in the experimental group were more significant than those in the control group， and the C-peptide levels in the experimental group were higher than those in the control group（P<0.05）; After three months of treatment， there was no statistically significant difference in blood glucose between the two groups of patients（P>0.05）; C peptide levels in the experimental group were higher than those in the control group（P<0.05）; blood glucose standard time in the experimental group was shorter than that in the control group（P<0.05）. Conclusion For patients with first-onset type 2 diabetes， intensive insulin treatment in the early stage can better control blood glucose changes， relieve high glucose toxicity， and have a better protective effect on islet B cell function.

[Key words] Insulin; First-onset type 2 diabetes; Islet B cells

糖尿病在目前临床上较为常见，导致这种病症发生的原因主要是患者的胰岛素分泌相对或绝对不足，进而引发的患者体内糖代谢紊乱，在这种状况下患者的机体功能会受到影响，并且患者血液粘稠度升高则容易引发患者出现心血管疾病[1-2]。而在对患者进行治疗时，需要应用药物对患者的病症进行长期控制，甚至部分患者需要终身用药才能对其血糖状况进行控制。过去对于2型糖尿病患者，一般在口服降糖药没有效果或者出现了其他急慢性并发症，才起始胰岛素进行治疗，但根据相关的实验显示，尽快的进行胰岛素强化治疗，对患者的胰岛功能有着较好的保护作用。该文通过该院于2016年8月—2017年8月期间进行治疗的初发2型糖尿病患者60例，评定对初发2型糖尿病采用早期胰岛素强化治疗，对胰岛B细胞功能的影响，现报道如下。