胰岛素泵持续输注门冬胰岛素强化治疗对磺脲类药物继发性失效的T2DM患者胰岛功能与炎性因子的影响

摘要

Objective To observe the effects of intensive therapy with continuous insulin aspart infusion on islet function and inflammatory factors in type 2 diabetes mellitus(T2DM) patients with secondary failure of sulfonylurea (SFS).Methods A total of 86 T2DM patients with SFS was randomly divided into two groups of A (treated with conventional multiple subcutaneous insulin injections,42 cases)and B(treated with continuous subcutaneous insulin aspart pumping,44 cases).The indicators related to blood glucose,insulin and inflammatory factors were detected before and after treatment for two weeks.The adverse effects were observed during treatment.Results After treatment for two weeks,the levels of FBG,HbA1c,HOMA-IR,2-h blood glucose after meal,hsCRP,IL-6 and TNF-α were decreased and HOMA-β,2-h insulin,C-peptide after meal were increased in two groups(P＜0.05).The levels of FBG,HbA1c,HOMA-IR,2-h blood glucose after meal,hsCRP,IL-6 and TNF-α were lower,but HOMA-β,2-h insulin and C-peptide after meal were higher,in group B than those in group A after treatment(P＜0.05).The incidence of adverse effects of two groups was similar(P＞0.05).Conclusion The intensive therapy by continuous insulin aspart pumping can reduce insulin resistance,improve β cell function,decrease inflammation factors in T2DM patients with SFS.%目的 观察胰岛素泵持续输注门冬胰岛素强化治疗对磺脲类药物继发性失效(SFS)的2型糖尿病(T2DM)患者的胰岛功能与炎性因子的影响.方法 SFS型T2DM患者86例随机分为对照组(42例)和观察组(44例).对照组采用分次皮下注射胰岛素法;观察组采用持续泵注门冬胰岛素.治疗2周后,检测血糖、胰岛素功能和炎症因子等相关指标.记录治疗期间不良反应.结果 治疗后,两组FBG、HbA1c、超敏C反应蛋白(hsCRP)、IL-6、TNF-α、HOMA-IR和餐后2-h血糖水平均降低,胰岛素分泌指数(HOMA-β)、餐后2-h的胰岛素和C-肽增高(P＜0.05).治疗后,观察组FBG、HbA1c、HOMA-IR、餐后2-h血糖、hsCRP、IL-6和TNF-α均低于对照组,HOMA-β、餐后2h的胰岛素和C-肽均高于对照组(P＜0.05).两组不良反应发生率相仿(P＞0.05).结论 胰岛素泵持续输注门冬胰岛素可减轻SFS型T2DM患者胰岛素抵抗,改善胰岛功能,降低机体炎性因子表达.