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目的观察口服药及胰岛素治疗对初发2型糖尿病患者β细胞功能的不同影响。方法 68例初诊2型糖尿病患者在饮食及运动干预下,随机分为胰岛素组(Ins)33例及口服药组(OHA)35例,观察两组治疗前后FPG、2hPG、HbA1c、C-p、Ins等相关指标。用胰岛素抵抗指数(HOMA-IR)评价胰岛素敏感性,用胰岛β细胞功能指数(HOMA-β)评价β细胞功能,用胰岛素初期分泌功能指数(△I30/△G30)评价糖负荷早期β细胞的分泌功能,并计算胰岛素曲线下面积(AUGIns)。结果 (1)随防至12个月时,Ins组和OHA组的HOMA-β、△I30/△G30、AUGIns均较治疗前明显升高,但Ins组效果优于OHA组,与OHA组比较差异有统计学意义(P<0.01);(2)HOMA-β、△I30/△G30及AUGIns水平均较治疗前显著升高(P<0.01),Ins组较OHA组升高更显著,差异有统计学意义(P<0.01)。结论对初发2型糖尿病患者选择胰岛素治疗可以更好地保护胰岛β细胞功能,而且这种保护可以产生长期的影响。
Objective To observe the different effects of oral medication and insulin therapy on β-cell function in newly diagnosed type 2 diabetic patients. Methods Sixty-eight patients with newly diagnosed type 2 diabetes were randomly divided into insulin group (33 cases) and oral medication group (35 cases) under diet and exercise intervention. The levels of FPG, 2hPG, HbA1c, Cp, Ins and so on Related indicators. Insulin sensitivity was evaluated by insulin resistance index (HOMA-IR), β-cell function was evaluated by islet β-cell function index (HOMA-β), and β-cell function was assessed by initial insulin secretion index (△ I30 / △ G30) Secretory function, and calculate the area under the curve of insulin (AUGIns). Results (1) The levels of HOMA-β, △ I30 / △ G30 and AUGIns in both Ins group and OHA group were significantly higher than those before treatment at 12 months, but the effect of Ins group was better than that of OHA group (P <0.01); (2) The levels of HOMA-β, △ I30 / △ G30 and AUGIns increased significantly compared with those before treatment (P <0.01) There was statistical significance (P <0.01). Conclusions Insulin treatment of newly diagnosed type 2 diabetes patients can better protect islet β-cell function, and this protection can have long-term effects.