早期胰岛素泵强化治疗对2型糖尿病患者胰高血糖素样多肽－1的影响效果

摘要

Objective To explore the impact of early insulin pump continuous subcutaneous insulin infusion ( Continuous subcutaneous insulin infusion , CSII) on glucagon like peptide -1 ( Glucagon-like peptide-1, GLP-1) of newly diagnosed obese and non obese type 2 diabetes mellitus (tyPe2diabetesmellitus, T2DM) patients.Methods 62 cases of T2DM patients were randomized into obese group ( Ob) and non obesity group (Non-Ob) according to body mass index (BMI) whether over 25kg/m2, 31 cases in each group, the clinical effects were compared between the two groups .Results For both two groups, FPG, 2hPG, GA and HOMA-IR significantly decreased compared with those before treatment .However, FINS, C -P and GLP -l increased significantly after treatment (P<0.05).The change amount of GLP -l, FPG, 2hPG, GA, FINS, HOMA-IR and C-P in Ob group were significantly higher than the Non Ob group (P<0.05).The change rate of BMI, WC and WHR of the two groups before and after treatment without significant differences ( P >0.05 ). Conclusions Early intensive insulin pump treatment can improve the sensitivity of βcells of newly diagnosed T2DM patients ( GLP -1 levels of both two groups were significantly increased ), increases the number of functional cells and promote the proliferation of P cells , and can effectively improve insulin resistance , especially for newly diagnosed obesity T2DM patients.%目的：探讨早期胰岛素泵持续皮下胰岛素输注治疗（ Continuous subcutaneous insulin infusion，CSII）对初诊肥胖与非肥胖2型糖尿病（Type 2 Diabetes Mellitus，T2DM）患者胰高血糖素样多肽－1（Glucagon －like peptide －1，GLP－1）影响的差异性。方法将62例T2DM患者按照体重指数（Body Mass Index，BMI）是否＞25 kg／m2随机分为肥胖组（Ob）31例和非肥胖组（Non－Ob）31例，并比较两组的临床效果。结果两组治疗后FPG、2 hPG、GA、HOMA－IR均较治疗前具有显著的下降，FINS、C－P、GLP－l均较治疗前显著的升高（P均＜0．05），Ob组GLP－l、FPG、2hPG、GA、FINS、HOMA－IR及C－P治疗前后变化量也显著的高于Non－Ob组（P均＜0．05），而两组BMI、WC、WHR治疗前后无统计学差异（P均＞0．05）。结论早期胰岛素泵强化治疗可改善初诊T2DM患者β细胞敏感性，两组GLP－1均明显的升高，增加功能细胞的数量和促进β细胞的增殖，能够有效的改善胰岛素抵抗，尤其对肥胖初诊T2 DM患者更加显著。