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目的探讨瑞格列奈联合口服葡萄糖耐量试验胰岛素释放试验(OGTT-IRT)评价新诊断的2型糖尿病(T2DM)患者胰岛β细胞功能的价值。方法 96例新诊断的T2DM患者在入组时行OGTT试验,其结果作为基线资料。将患者随机分为3组,A组服单次瑞格列奈行OGTT,B组服1周瑞格列奈行OGTT,C组服1周格列本脲行OGTT。测定各时刻真胰岛素(TI)和免疫反应性胰岛素(IRI),并计算TI/IRI及早时相胰岛素分泌指数△I_(30)/△G_(30)。结果 A组和B组服药后30 min时TI和TI/IRI较基线明显增加(P<0.05),△I_(30)/△G_(30)均较基线显著升高(P<0.01);C组服药前后上述指标均无统计学差异。结论瑞格列奈改善早时相胰岛素分泌,其联合OGTT-IRT较常规OGTT-IRT能更真实反映新诊断的T2DM患者胰岛β细胞分泌和储备功能。
Objective To investigate the value of repaglinide combined with oral glucose tolerance test insulin release test (OGTT-IRT) in the evaluation of pancreatic β-cell function in patients with newly diagnosed type 2 diabetes mellitus (T2DM). Methods 96 newly diagnosed T2DM patients were enrolled in the OGTT test, the results as a baseline data. The patients were randomly divided into three groups: group A received single repaglinide OGTT; group B received repaglinide one week; group C received one week of glyburide OGTT. Real time insulin (TI) and immunoreactive insulin (IRI) were measured at each time point, and TI / IRI and early phase insulin secretion index △ I_ (30) / △ G_ (30) were calculated. Results The levels of TI and TI / IRI in group A and group B were significantly increased (P <0.05) and the values of △ I_ (30) / △ G_ (30) were significantly higher than those in baseline at 30 min There was no significant difference in the above indexes before and after taking the medicine. Conclusions Repaglinide can improve early phase insulin secretion. Combined with OGTT-IRT, repaglinide can more accurately reflect the function of pancreatic β-cell secretion and reserve in newly diagnosed T2DM patients.