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目的观察早期胰岛素泵治疗对新诊断的2型糖尿病(T2DM)患者血胰升血糖素样肽1(GLP-1)的影响。方法选择T2DM患者100例,根据病程分为两组:试验组40例,为新诊断的T2DM患者(病程<1年);对照组60例,为T2DM患者(病程1～10年)。两组均使用胰岛素泵持续皮下输注超短效胰岛素门冬胰岛素(诺和锐)2周。比较两组FPG、2hPG、糖化血清白蛋白(GA)、空腹GLP-1、FC-P等变化情况及其相关性。结果治疗后两组FPG、2hPG、GA、FC-P、空腹GLP-1的差异均有统计学意义(P<0.05);两组治疗前后变化量比较有统计学意义(P<0.05)。GLP-1与FC-P呈正相关,与FPG、2hPG及GA呈负相关。结论早期胰岛素泵治疗能够很好控制血糖,促进胰岛功能恢复。对于新诊断的糖尿病患者,GLP-1显著升高,表明胰岛素泵早期治疗在改善β细胞功能、部分恢复餐后胰岛素早时相分泌方面有重要作用,而这种作用在1年以上病程的患者中表现相对不明显。
Objective To investigate the effect of early insulin pump therapy on the serum glucagon-like peptide 1 (GLP-1) in newly diagnosed type 2 diabetes mellitus (T2DM). Methods Totally 100 T2DM patients were divided into two groups according to their duration of disease: 40 patients in the experimental group were newly diagnosed T2DM patients (duration of disease <1 year); 60 patients in the control group were T2DM patients (duration of 1 to 10 years). Both groups were given insulin pump for sustained subcutaneous infusion of ultra-short-acting insulin aspart insulin (Connaught sharp) for 2 weeks. The changes of FPG, 2hPG, GA, fasting GLP-1 and FC-P in the two groups were compared. Results The differences of FPG, 2hPG, GA, FC-P and fasting GLP-1 between the two groups after treatment were statistically significant (P <0.05). The changes of the two groups were statistically significant before and after treatment (P <0.05). GLP-1 was positively correlated with FC-P and negatively correlated with FPG, 2hPG and GA. Conclusion Early insulin pump treatment can be very good control of blood glucose, promote pancreatic islet function recovery. GLP-1 is significantly elevated in newly diagnosed diabetic patients, indicating that early treatment with insulin pump plays an important role in improving β-cell function and partly in restoring early postprandial insulin secretion, which is effective in patients over 1 year In the relatively poor performance.