CAJ | 학술논문

目的探讨瑞格列奈短期强化治疗对改善新诊断2型糖尿病(T2DM)患者的胰岛β细胞功能及长期血糖控制的影响. 方法采用自身前后对照和组间对照方法 ,观察80例空腹血糖(FPG)<11.1 mmol/L,餐后2 h血糖(PG2h)<15 mmol/L,糖化血红蛋白(HbA1c)<10.0%的新诊断T2DM患者接受瑞格列奈(诺和龙)短期强化治疗前后胰岛β细胞对血糖刺激的胰岛素早时相分泌(△I30/△G30比值)、血脂、胰岛素分泌(Homa)指数A、Homa B的变化. 结果治疗后,75 g口服葡萄糖试验(OGTT)、成功组、中间组、失败组空腹血糖分别从(8.9±1.5)、(8.6±1.6)、(9.0±2.0)mmol/L降至(5.0±1.4)、(6.3±0.7)、(6.5±0.9)mmol/L,餐后0.5 h血糖分别从(12.6± 1.6)、(12.6±1.5)、(12.4±1.3)mmol/L降至(8.4±1.0)、(6.8±0.7)、(8.6±0.9)mmol/L,餐后2h血糖分别从(13.0±1.2)、(13.1±1.3)、(13.3±1.4)mmol/L降至(9.2±0.9)、(6.6±0.7)、(9.2±0.9)mmol/L,差异有统计学意义(P<0.005);△I30/△G30比值;成功组和中间组,失败组分别从1.69±0.31、1.72±0.33和平共处.79±0.36升高到4.47±0.62,4.42±0.46和2.00±0.46均有明显改善(P<0.05);Homa B明显升高(P<0.05),Homa A、三酰甘油(TG)明显下降(P<0.05).其中有21例患者超过6个月(最长达18个月)仅采用生活方式干预,空腹及餐后血糖均维持在正常范围;成功组与失败组相比,在△I30/△G30比值(4.47±0.62与2.0±0.46)、年龄((39±8)岁与(56±9岁)]、诺和龙最终用量[(2.0±1.5)g与(5.0±2.5)g3、血糖达标时间[(32.4±8.0)个月与(53.3±7.6)个月]比较差异均有统计学意义(P<0.05). 结论短期瑞格列奈强化治疗可以恢复代表胰岛β细胞功能的血糖刺激的胰岛素早时相分泌,重塑胰岛素分泌的生理模式,有效缓解糖尿病病情.
목적 탐토서격렬내단기강화치료대개선신진단2형당뇨병(T2DM)환자적이도β세포공능급장기혈당공제적영향. 방법 채용자신전후대조화조간대조방법 ,관찰80례공복혈당(FPG)<11.1 mmol/L,찬후2 h혈당(PG2h)<15 mmol/L,당화혈홍단백(HbA1c)<10.0%적신진단T2DM환자접수서격렬내(낙화룡)단기강화치료전후이도β세포대혈당자격적이도소조시상분비(△I30/△G30비치)、혈지、이도소분비(Homa)지수A、Homa B적변화. 결과 치료후,75 g구복포도당시험(OGTT)、성공조、중간조、실패조공복혈당분별종(8.9±1.5)、(8.6±1.6)、(9.0±2.0)mmol/L강지(5.0±1.4)、(6.3±0.7)、(6.5±0.9)mmol/L,찬후0.5 h혈당분별종(12.6± 1.6)、(12.6±1.5)、(12.4±1.3)mmol/L강지(8.4±1.0)、(6.8±0.7)、(8.6±0.9)mmol/L,찬후2h혈당분별종(13.0±1.2)、(13.1±1.3)、(13.3±1.4)mmol/L강지(9.2±0.9)、(6.6±0.7)、(9.2±0.9)mmol/L,차이유통계학의의(P<0.005);△I30/△G30비치;성공조화중간조,실패조분별종1.69±0.31、1.72±0.33화평공처.79±0.36승고도4.47±0.62,4.42±0.46화2.00±0.46균유명현개선(P<0.05);Homa B명현승고(P<0.05),Homa A、삼선감유(TG)명현하강(P<0.05).기중유21례환자초과6개월(최장체18개월)부채용생활방식간예,공복급찬후혈당균유지재정상범위;성공조여실패조상비,재△I30/△G30비치(4.47±0.62여2.0±0.46)、년령((39±8)세여(56±9세)]、낙화룡최종용량[(2.0±1.5)g여(5.0±2.5)g3、혈당체표시간[(32.4±8.0)개월여(53.3±7.6)개월]비교차이균유통계학의의(P<0.05). 결론 단기서격렬내강화치료가이회복대표이도β세포공능적혈당자격적이도소조시상분비,중소이도소분비적생리모식,유효완해당뇨병병정.
Objective To explore the effect of repaglinide intensive treatment on islet β-cell function and long-term control of blood glucose in newly diagnosed type 2 diabetic patients. Methods Self-control and inter-group control prospective study was conducted in 80 newly diagnosed type 2 diabetic patients who were treated with short-term repaglinide intensive treatment and islet β-cell function was assessed by 75 g oral glucose tolerance test (OGTT) before and after repaglinide treatment. The changes of △I30/△G30 ratio, blood lipid, HOMA A and HOMA B were examined. Results After treatment, in successful group, middle group and defeat group, the fasting plasma glucose levels were decreased from 8.9±1.5, 8.6±1.6,9.0±2.0 to 5.0±1.4,6.3±0. 7,6.5±0. 9 mmol/L, 0. 5 h postprandial glucose levels were decreased from (12.6±1.6, 12.6±1.5, 12.4±1.3 to 8.4±1.0, 6.8±0. 7, 8. 6±0. 9)mmol/L,and 2 h postprandial glucose levels were decreased from (13.0±1.2, 13. 1±1.3, 13. 3±1.4 to 9.2±0.9, 6.6±0. 7, 9.2±0. 9)mmol/L,respectively (all P <0. 005). The ratio of △I30/△G30 was increased froml. 69±0. 31, 1.72±0. 33, 1.79±0. 36 to 4. 47±0. 62, 4. 42±0.46,12. 00±0.46 in the three groups, respectively (P<0.05). HOMA B was significantly improved (P<0. 05), while triglycerides and HOMA A were decreased(P<0. 05). The levels of fasting blood glucose and postprandial blood glucose in 21 patients were maintained within normal range for more than six months. There were significant differences in the ratio of △I30/△G30, age, repaglinide dosage and the time of reaching target of glucose [4.47±0.62 vs. 2. 0± 0.46; 39±8 vs. 56±9; 2.0±1.5 vs. 5.0±2.5; 32.4±8.0 vs. 53.3±7.6; all P<0.05] between successful group and defeat group. Conclusions The short-term intensive treatment with repaglinide can significantly improve the early secretion phase of insulin and the islet β-cell function, reconstruct of the physiological model of insulin secretion and relieve the disease.