胰岛素泵治疗对不同 BMI 酮症起病的2型糖尿病患者胰岛功能的影响

摘要

目的：探讨胰岛素泵治疗对不同 BMI 的酮症起病的2型糖尿病患者胰岛功能的影响。方法：选择酮症起病的2型糖尿病患者50例，以 BMI 24 kg／m2为界，分为肥胖组28例和非肥胖组22例，均采用胰岛素泵强化治疗2周，并随访15周。应用稳态模型评估胰岛素抵抗指数和胰岛β细胞功能。观察患者治疗前、治疗后2周、治疗后15周胰岛素抵抗指数和胰岛β细胞功能的变化。结果：治疗前肥胖组与非肥胖组胰岛功能差异无统计学意义（P ＞0.05）；治疗后两组胰岛功能均有明显改善（P ＜0.05），肥胖组较非肥胖组改善更明显（P ＜0.05），差异有统计学意义。结论：胰岛素泵强化治疗能显著改善酮症起病的2型糖尿病患者的胰岛功能，减轻胰岛素抵抗，尤其肥胖患者胰岛功能改善更明显。%Objective To evaluate the influence of the insulin pump treatment on beta cell function in patients with ketosis -onset diabetes about the different body mass index.Method Fifty inpatients with ketosis -onset diabetes were divided into two groups such as the obesity group(n =28)and the Non -obesity group(n =22),according to the body mass index lim it 24 kg/m2.All patientsw ere treated by insulin pump for two weeks.HOMA -IR and HOMA -βwere used to estimate insulin sensitivity and β-cell function respectively on three separate occasions.The occasions were the visits before trestment,after 2 weeks and af-ter 15 weeks.Results There was no obviously differences in the beta cell function between two groups before treatment,the differ-ence was not statistically significant (P >0.05).After treatments,both the beta cell functions of two groups were improved signif-icantly,the difference was statistically significant (P <0.05),the beta cell functions of the obesity group were improved signifi-cantly,compared to the Non -obesity group,the difference was statistically significant (P <0.05).Conclusion The beta cell functions of both groups is improved after the treatments of insulin pump,the Obesity group is improved significantly.