胰岛素泵强化治疗对降糖药继发性失效的2型糖尿病患者炎性细胞因子及胰岛功能的影响

摘要

目的 观察胰岛素泵强化治疗对降糖药继发性失效(SFS)的2型糖尿病患者炎性细胞因子及胰岛功能的影响.方法 50例SFS的2型糖尿病患者停用口服降糖药,改用胰岛素泵强化治疗2周,观察治疗前后的空腹血糖、餐后2-h血糖、胰岛素抵抗指数(HOMA-IR)、胰岛素分泌指数(HOMA-β)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平的变化.结果 强化治疗后,患者空腹血糖、餐后2-h血糖、HOMA-IR、TNF-α、IL-6水平均较治疗前明显下降(P＜0.05),HOMA-β较治疗前明显增高(P＜0.05).结论 胰岛素泵强化治疗可减轻SFS的2型糖尿病患者胰岛素抵抗,改善胰岛β细胞功能,降低机体炎性因子水平.%Objective To observe the effects of intensive insulin analogues therapy on function of pancreatic β-cell, inflammatory cell factor in the sulfonylurea secondary failure(SFS) patients with type 2 diabetes mellitus(T2DM). Methods The intensive treatment with insulin pump instead of oral glucose-lowering medications was performed in 50 T2DM cases with SFS. The intensive treatment lasted fo two weeks and fasting blood glucose ( FBG) , islet function and serum levels of TNF-α and IL-6 were examined before and after treatment. Results After intensive therapy, FBG, postprandial 2-h BG,insulin resistance index(HOMA-IR),TNF-a and IL-6 were lower,but insulin secretion index (HOMA-P) was higher, after treatment than those before(P<0. 05). Conclusion Insulin intensive therapy can reduce insulin resistance, improve beta cell function, decrease the levels of the inflammation factors in the T2DM patients with SFS.