摘要目的 探究早期胰岛素强化治疗后转换不同降糖方案治疗新诊断2型糖尿病的效果。方法 选取2017年1月～2018年1月我院收治的84例新诊断2型糖尿病患者，患者均接受胰岛素强化治疗2周，待血糖控制达标后采用随机数字表法将患者分为基础胰岛素组和口服降糖药组，每组各42例。强化治疗前后对患者的血脂、血糖水平等进行测定，并进行1年的随访。结果 经胰岛素强化治疗后的三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）以及糖化血红蛋白（HbAlc）、空腹血糖（FBG）、糖负荷后2 h 血糖（2 h PBG）均低于治疗前，空腹胰岛素（FINS）、胰岛素、HOMA-胰岛素分泌指数（HOMA-IS）和胰岛素抵抗指数（HOMA-IR）均高于治疗前，差异有统计学意义（P＜0.05）；胰岛素强化治疗前后的体重指数（BMI）、腰臀比（WHR）、体脂率和高密度脂蛋白胆固醇（HDL-C）比较，差异无统计学意义（P＞0.05）。随访1年后，基础胰岛素组和口服降糖药组患者的HbA1c、FBG、2 h PBG、HOMA-IS 和HOMA-IR 比较，差异均无统计学意义（P＞0.05）。结论 胰岛素强化治疗能够有效改善2型糖尿病患者的血糖、血脂水平，强化治疗后采用基础胰岛素和口服降糖药物均能取得较为满意的临床效果。
Abstract：Objective To explore effect of switching different hypoglycemic regimens in the treatment of newly diagnosed type 2 diabetes mellitus after early intensive insulin therapy.Methods A total of 84 patients with newly diagnosed type 2 diabetes mellitus who were admitted to our hospital from January 2017 to January 2018 were enrolled.All of them underwent intensive insulin therapy for 2 weeks.After blood glucose control was qualified,they were divided into the basic insulin group and the oral hypoglycemic group by the random number table method,42 cases in each group.The levels of blood lipid and blood glucose were measured before and after intensive treatment.The follow-up was conducted for 1 year.Results After intensive insulin treatment,triglyceride (TG),total cholesterol (TC),low density lipoprotein-cholesterol (LDL-C),glycated hemoglobin (HbAlc),fasting blood-glucose (FBG) and two hours postprandial blood glucose (2 h PBG) were lower than those before treatment,while fasting insulin (FINS),insulin,homeostatic model assessment of insulin sensitivity (HOMA-IS) and homeostatic model assessment of insulin resistance (HOMA-IR)were higher than those before treatment,the differences were statistically significant (P＜0.05).There were no statistically significant differences in body mass index (BMI),waist-to-hip ratio (WHR),body fat rate and high density lipoprotein-cholesterol (HDL-C) before and after treatment (P＞0.05).One year later,there were no statistically significant differences in HbA1c,FBG,2 h PBG,HOMA-IS and HOMA-IR between the basic insulin group and the oral hypoglycemic group (P＞0.05).Conclusion Intensive insulin therapy can effectively improve levels of blood glucose and blood lipid in patients with newly diagnosed type 2 diabetes mellitus.After intensive treatment,both the use of basic insulin and oral hypoglycemic drugs can achieve satisfactory clinical results
伊正元. 早期胰岛素强化治疗后转换不同降糖方案治疗新诊断2型糖尿病的效果[J]. 中国当代医药, 2020, 27(31): 90-92.
YI Zheng-yuan. Effect of switching different hypoglycemic regimens in the treatment of newly diagnosed type 2 diabetes mellitus after early intensive insulin therapy. 中国当代医药, 2020, 27(31): 90-92.
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