Abstract：Objective: To investigate the effect of short term intensive insulin therapy on blood glucose in patients with type 2 diabetes. Methods: 120 cases of type 2 diabetic patients were Selected from January 2015 to December 2016 in Department of Endocrinology as the object of study. Patients were divided into control and observation group by stratified randomization, 60 cases in each group. Patients in the two groups were underwent diabetic education and diet, exercise therapy; Based on the routine therapy, patients in the control group were given metformin therapy; patients in the observation group were given islet hormone intensive therapy, such as subcutaneous injection Novolin R (short acting insulin ), three times daily, 30 minutes before meals and subcutaneous injections Novolin N (acting insulin)three times daily before bedtime. Based on the glycemic control to adjust the dose of insulin, continuous treatment for 1 month. Regular follow-up 3 months, fasting insulin (fins), insulin resistance index (HOMA-IR), fasting C peptide (fc-p), postprandial 2H C-peptide (2H C-P), postprandial 2 h insulin level (Hins)were compared between the two groups to assess islet beta cell function; Besides, fasting blood glucose (FBG), 2hPG (2 h postprandial blood glucose, glycosylated hemoglobin (HbA1c) level and the adverse reactions were also compared. Results: After treatment, fins, fc-p, 2h C-P, 2 Hins significantly increased that compared with before treatment, and higher significant increasing at observation group, the difference were statistically significant (P<0.05). After treatment, HOMA-IR level in patients of the two group was decreased that compared with before treatment, and more lower values was observed at observation group, the difference was statistically significant (P < 0.05). Before treatment, the levels of FBG, 2Hpg and HbA1c in patients of the two groups were not significantly different; While, they were significantly decreased and more lower values observed at observation group, the difference was statistically significant. There were no obvious heart, liver and kidney function damage in patients of the two groups and without obvious adverse reactions in the control group, only 1 patient appeared low blood sugar glucose. Conclusion: Short term intensive insulin therapy can improve islet beta cell function in patients with type 2 diabetes mellitus, and maintain the normal range of blood glucose, which is of clinical value.
冉卡娜, 张云庆, 徐刚, 方永碧, 周沁. 短期胰岛素强化治疗对2型糖尿病患者血糖长期控制的效果[J]. 河北医学, 2017, 23(10): 1699-1701.
RAN Kana, ZHANG Yunqing, XU Gang, et al. Effect of Short Term Intensive Insulin Therapy on Blood Glucose |in Patients with Type 2 Diabetes. 河北医学, 2017, 23(10): 1699-1701.
[1]中国医师协会营养医师专业委员会.中国糖尿病医学营养治疗指南(2013)[J].中国糖尿病杂志,2015,10(2):73. [2] Liu L, Ke W,Wan X,et al.Insulin requirement profiles of short-term intensive insulin therapy in patients with newly diagnosed type 2 diabetes and its association with long-term glycemic remission[J].Diabetes Res Clin Pract,2015,108(2):250~257. [3] 廖涌.中国糖尿病的流行病学现状及展望[J].重庆医科大学学报,2015(7):1042~1045. [4] Bharucha AE, Kudva Y, Basu A, et al. Relationship between glycemic control and gastric emptying in poorly controlled type 2 diabetes[J].Clin Gastroenterol Hepatol,2015,13(3):466~476. [5] Pfutzner A, Dissel S, Forkel C,et al. Standardized modulation of the injection site allows for insulin dose reduction without deterioration of metabolic control[J].Curr Med Res Opin,2014,30(10):2001~2008. [6] Fujiwara D, Takahashi K, Suzuki T,et al.Postprandial serum C-peptide value is the optimal index to identify patients with non-obese type 2 diabetes who require multiple daily insulin injection: Analysis of C-peptide values before and after short-term intensive insulin therapy[J].Diabetes Investig,2013, 4(6):618~625. [7] Cheng Q, Yang S, Zhao C,et al.Efficacy of metformin-based oral antidiabetic druRKELgs is not inferior to insulin glargine in newly diagnosed type 2 diabetic patients with severe hyperglycemia after short-term intensive insulin therapy[J].Diabetes,2015,7(4):182~191. [8] Schauer PR, Bhatt DL, Kirwan JP,et al.Bariatric surgery versus intensive medical therapy for diabetes-3-year outcomes[J].N Engl Med,2014,370(21):2002~13. [9] Harrison LB, Adams-huet B, LI X,et al.Intensive therapy in newly diagnosed type 2 diabetes: results of a 6-year randomized trial[J].Investig Med,2014,62(4):676~686. [10] Kramer CK, Choi H, Zinman B, et al.Glycemic variability in patients with early type 2 diabetes: the impact of improvement in β-cell function[J].Diabetes Care,2014,37(4):1116~1123. [11] Lv WS, Li L, Wen JP, et al.Comparison of a multiple daily insulin injection regimen (glargine or detemir once daily plus prandial insulin aspart) and continuous subcutaneous insulin infusion (aspart) in short-term intensive insulin therapy for poorly controlled type 2 diabetes patients[J].International Journal of Endocrinology,Volume 2013 (2013), Article ID 614242, 6 pages [12] Shimodira M, Murova Y, Kumagai N,et al.Effects of short-term intensive glycemic control on insulin, glucagon, and glucagon-like peptide-1 secretion in patients with Type 2 diabetes[J].Endocrinol Inves,2013,36(9):734-8. [13] Xu W, Weng J.Current role of short-term intensive insulin strategies in newly diagnosed type 2 diabetes[J].Diabetes,2013,5(3):268~274. [14] Lin X H, Xu M T, Mail F, et al. Influence of short-term intensive insulin therapy on plasma concentration of lipoprotein-associated phospholipase A(2) and secretory phospholipase A(2) in newly diagnosed type 2 diabetic patients[J].Zhonghua Nei Ke Za Zhi, 2017, 56(2):127.
2017, Vol. 23 
冀公网安备13080202000677号