初诊T2DM患者短期胰岛素泵强化治疗后后续治疗方案选择

发布时间：2018-05-24 02:11

本文选题：型糖尿病 + 胰岛素泵强化治疗　；参考：《山东医药》2017年28期

【摘要】：目的探讨初诊2型糖尿病(T2DM)患者短期胰岛素泵强化治疗后最佳后续治疗方案。方法选择经短期胰岛素泵强化治疗后血糖控制达标的初诊T2DM患者84例,随机分为观察组、对照组各42例。对照组后续给予口服降糖药治疗,观察组后续给予基础胰岛素皮下注射治疗。分别于治疗前和随访2年时,检测两组空腹血糖(FPG)、糖化血红蛋白(Hb A1c)及空腹C肽(FCP),计算BMI及胰岛素分泌指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR);同日检测颈动脉内膜-中膜厚度(IMT),计算颈动脉斑块检出率。结果两组治疗后Hb A1c、BMI均低于治疗前(P均0.05),但两组治疗后比较差异无统计学意义(P均0.05)。两组治疗后HOMA-IR均低于治疗前,HOMA-β均高于治疗前,且以观察组治疗后变化更明显(P均0.05)。对照组治疗后颈动脉IMT高于治疗前(P0.05),但观察组治疗前后比较差异无统计学意义(P0.05),观察组治疗后颈动脉IMT低于对照组治疗后(P0.05)。两组治疗前后颈动脉斑块检出率比较差异均无统计学意义(P均0.05)。结论初诊T2DM患者短期胰岛素泵强化治疗后皮下注射胰岛素后续治疗对改善胰岛功能的效果优于口服降糖药后续治疗。
[Abstract]:Objective to explore the best method of short-term insulin pump intensive treatment for newly diagnosed type 2 diabetes mellitus (T2DM) patients. Methods Eighty-four patients with T2DM after short-term intensive insulin pump therapy were randomly divided into observation group (n = 42) and control group (n = 42). The control group was treated with oral hypoglycemic drugs and the observation group with subcutaneous injection of basic insulin. Before treatment and 2 years follow-up, BMI, insulin secretion index (HOMA- 尾), insulin resistance index (HOMA-IRN) and carotid intima-media thickness (IMT) were measured on the same day, and the detection rate of carotid plaque was calculated. Results after treatment, the BMI of HB A1cN in the two groups was lower than that before treatment (P 0.05), but there was no significant difference between the two groups after treatment (P 0.05). After treatment, HOMA-IR in both groups was lower than that before treatment, and the changes of HOMA- 尾 in observation group were more obvious than those before treatment (P < 0.05). The IMT of carotid artery in the control group was higher than that in the control group before and after treatment, but there was no significant difference before and after treatment in the observation group. The IMT of the carotid artery in the observation group was lower than that in the control group after treatment. There was no significant difference in the detection rate of carotid plaque between the two groups before and after treatment (P < 0.05). Conclusion the effect of subcutaneous insulin injection on the improvement of islet function in patients with newly diagnosed T2DM after short-term intensive insulin pump therapy is better than that of oral hypoglycemic drugs.
【作者单位】：承德市中心医院;
【基金】：河北省医学科学研究重点课题计划(20160307)
【分类号】：R587.1

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