摘要目的 探讨短期胰岛素泵强化治疗对新诊断2型糖尿病患者胰岛素敏感性和胰岛素分泌功能的影响.方法 选取2006年6月至2007年2月在本院就诊的新诊断2型糖尿病患者10例进行为期2周的胰岛素泵强化治疗,在治疗前和停泵24 h后分别进行两次静脉葡萄糖耐量试验(IVGTT)和高胰岛素-正葡萄糖钳夹试验.结果 (1)在治疗前所有糖尿病患者均缺乏急性胰岛素分泌(AIR),经2周强化治疗使血糖正常后,所有患者AIR均有了不同程度地恢复[(7.63±4.73 vs 0.83±1.96)mU/L,P＜0.01)].AIR恢复较好的患者略为年轻和肥胖.(2)糖耐量正常志愿者平均葡萄糖输注率(GIR)为(8.26±2.48)mg·kg-1·min-1,而初发2型糖尿病患者在胰岛素泵强化治疗前GIR为(2.30±0.81)mg·kg-1·min-1(与正常者比,P＜0.01),胰岛素泵强化治疗后GIR升高到(5.33±1.43)mg·kg-1·min-1(P＜0.01).GIR升高显著的患者腰围和体重指数低、治疗前的平均血糖高.结论 短期胰岛素泵强化治疗使血糖"正常化",同时可改善胰岛细胞功能,提高胰岛素敏感性.

abstractsObjective To explore the impacts of short-term continuous subcutaneous insulin infusion (CSII) therapy on insulin secretion and sensitivity in newly-diagnosed type 2 diabetes. Methods Ten patients(7 males, 3 females) with newly-diagnosed type 2 diabetes accepted a 2-week course of intensive CSII therapy during June 2006 and February 2007. Hyperinsulinemia euglycemia clamp test and intravenous glucose tolerance test (IVGTT) were performed before and after CSII. Results (1) None of the patients had acute insulin response (AIR) before CSII treatment, and most of them had a partial restoration after 2-week intensive therapy. The AIR after CSII was significantly increased [(7.63±4.73 vs 0.83±1.96)mU/L, P＜0.01]. The patients whose AIR restored better tend to be younger and obeser. (2) The glucose infusion rate (GIR) before CSII in the newly-diagnosed type 2 diabetic patients was significantly lower than that in healthy controls [(2.30±0.81 vs after 2-week CSII therapy (P＜0.01). The patients whose GIR increased greatly had significantly lower waist circumferences and body mass index, and higher basal blood glucose levels. Conclusion Normalization of blood glucose levels by transient intensive CSII therapy improves pancreas β-cell function and insulin sensitivity, which seems to contribute to the long-term diabetic remission.