摘要
目的探讨不同类型胰岛素对初发2型糖尿病(T2DM)患者血糖、糖化血红蛋白(HBA1c)及胰岛B细胞功能的影响。方法将张家港市中医院内分泌科2013年6月—2014年8月收治的初发T2DM患者90例分为诺和灵30R组、诺和锐30组、甘精胰岛素组,每组30例。甘精胰岛素组采用每天固定时间注射甘精胰岛素,诺和灵30R组采用早餐和晚餐前30 min注射预混胰岛素,诺和锐30组采用早餐和晚餐时即刻注射门冬胰岛素。每组在治疗前均检测体质量指数(BMI)、Hb A1c、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C),并行口服葡萄糖耐量试验(OGTT)-胰岛素释放试验,分别在0、30、60、120、180 min测定血糖、胰岛素,使用稳态模型评估胰岛素抵抗程度、胰岛B细胞功能。治疗后12周再次测定并计算上述指标,对比3组间的差异。结果诺和灵30R组、诺和锐30组及甘精胰岛素组治疗后12周血糖、HBA1c、稳态模型胰岛素抵抗指数(HOMA-IR)均较本组治疗前明显降低(P<0.05)、稳态模型胰岛素分泌指数(HOMA-B)明显升高(P<0.05);BMI及空腹血糖甘精胰岛素组显著低于其他两组(P<0.05)。60 min血糖诺和锐30组显著低于其他两组(P<0.01);HOMA-B诺和灵30R组显著低于其他两组(P<0.05);甘精胰岛素组低血糖发生率明显低于其他两组(P<0.05)。结论门冬胰岛素、预混胰岛素和甘精胰岛素均能有效控制初发T2DM血糖、减轻胰岛素抵抗、改善胰岛B细胞功能,甘精胰岛素疗效不逊于预混胰岛素与门冬胰岛素,且低血糖发生率低、患者治疗依从性好。
Objective To investigate the effects of different types of insulin on blood glucose,gyrated hemoglobin（ HBA1c） and insular B cell function of patients with primary type 2 diabetes mellitus（ T2DM）.Methods A total of 90 patients with primary T2 DM admitted during June 2013 and Augest 2014 were randomly divided into Novolin 30 R group（ n = 30）,Novo Mix 30 group（ n = 30） and Glargine group（ n = 30）.Glargine group was injected with Glargine at the same time every day,and Novolin 30 R group was injected with Premixed Insulin（ Novolin 30R） at 30 min before breakfast and dinner,and Novo Mix 30 group was injected with Insulin Aspart（ Novo Mix 30 right） right at breakfast and dinner.The body mass index（ BMI）,levels of HBA1 c,triglyceride（ TG）,total cholesterol（ TC） and low-density lipoprotein cholesterol（ LDL-C） were tested,and levels of blood glucose and insulin were detected at 0,30,60,120 and180 min before treatment using oral glucose tolerance test（ OGTT）-insulin releasing test,and the insulin resistance index（ HOMA-IR） and insular B cell function were evaluated using steady state model for all patients.The above indexes were detected and calculated again after 12 weeks of treatment,and the differences were compared among the 3 groups.Results Compared with those before treatment in the same group,levels of blood glucose,HBA1 c and HOMA-IR were significantly decreased,while the insulin secretion index（ HOMA-B） levels were significantly increased in Novolin 30 R,Novo Mix 30 and Glargine groups after 12 weeks of treatment（ P〈0.05）.BMI and fasting plasma glucose levels in Glargine group were significantly lower than those in the other two groups（ P〈0.05）.The blood glucose level at 60 min before treatment in Novo Mix 30 group was significantly lower than those in the other two groups（ P〈0.01）.HOMA-B level in Novolin 30 R group was significantly lower than those in the other two groups（ P〈0.05）.The incidence rate of hypoglycemia insulin in Glargi
出处
《解放军医药杂志》
CAS
2016年第5期70-74,共5页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
张家港市科技局2013年社会发展支撑项目(ZKS1319)
关键词
胰岛素
糖尿病
2型
糖化血红蛋白
胰岛B细胞
Insulin
Diabetes mellitus
type 2
Glycosylated hemoglobin
Insular B cell
