胰岛素泵与皮下注射胰岛素对新诊断2型糖尿病胰岛素早期分泌的影响.docVIP

胰岛素泵与皮下注射胰岛素对新诊断2型 糖尿病胰岛素早期分泌的影响研究 张星光 吕肖锋2 刘静 焦秀敏 (北京军区总医院内分泌科,北京100700) 目的 比较持续性皮下胰岛素输注（CSII）两周及多次皮下胰岛素注射（MSII）两周治疗前后胰岛β细胞第一时相胰岛素分泌的变化。 方法 将新诊断的2型糖尿病患者随机分为两组，（1）CSII组，20例患者；（2）MSII组，18例患者。治疗前后均进行静脉葡萄糖耐量试验（IVGTT），测定0、1、3、5、10分钟血浆胰岛素、血糖，来比较各组患者治疗前后自身及相互之间的胰岛β细胞第一时相胰岛素功能变化情况。 结果 两组治疗前后各点血浆胰岛素均明显升高（P0.01）；CSII组升高更为明显，与 MSII组比较有显著差异（P0.01）。 结论 胰岛素泵强化治疗和多次皮下注射胰岛素均可改善新诊断2型糖尿病患者的胰岛β细胞第1时相胰岛素分泌，胰岛素泵强化治疗作用更为明显。 关键词 2型糖尿病，胰岛素泵，第1时相胰岛素 Effect of Insulin Pumps and Subcutaneous Injection of Insulin on the newly diagnosed type 2 diabetes mellitus first-phase insulin secretion ZHANG Xingguang , LU Xiaofeng LIU Jing JIAO Xiumin Department of Endocrinology Metabolism, General Hospital of Beijing Military Area, Beijing 100700, China Abstract:Objective: To compare the therapeutic effects and safety of continuous subcutaneous insulin infusion by insulin pump (CSII) and multiple subcutaneous insulin injection (MSII) in treatmentof newly diagnosed type 2 diabetes mellitus on the β-cell functionality. Methods: Totally, 38 cases of newly diagnosed type 2 diabetes mellitus were randomly assigned into two groups, CSII group ( n =20) and MSII group ( n =18). Before and after the treatment, the Intravenous Glucose Tolerance Test (IVGTT) were conducted to get the first-phase insulin secretion and level of blood glucose. Results: The blood insulin levels in two group was significantly higher than that before treatment ( P 0. 01), That in CSII group was significantly better than that in MSII group ( P 0. 01). Conclusions: The first-phase insulin secretion was improved by treatment with CSII and MSII,but CSII was better than MSII. Key words: Diabetes mellitus; Insulin pumping; the first-phase insulin 随着经济的增长、人民生活方式的改变，人口老龄化等诸多因素的加深，导致了糖尿病发病率的迅猛增长。使其成为危害我国人民健康、阻碍社会发展的严重公共卫生问题。目前研究认为胰岛素泵强化治疗后，能够使胰岛β /l和或餐后2h血糖大于14mmol/l。排除合并严重的感染；严重的心、肝、肾功能不全；酮症酸中毒及伴有其他糖代谢的疾病患者。按照随机原则将患者分为使用胰岛素泵(continuous subcutaneous insulin injection, CSII)组和皮下注射胰岛素(multip lesubcutaneous insulin injection, MSII)组, CSII治疗组20例，