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目的探讨联合使用罗格列酮和赖脯25胰岛素治疗初诊2型糖尿病患者后,患者胰岛β细胞功能的恢复情况。方法 56例初诊2型糖尿病患者在使用罗格列酮和赖脯25胰岛素治疗半个月前后,分别进行口服葡萄糖-胰岛素兴奋试验(OGIRT),测定各个时点的血糖、胰岛素,计算胰岛素抵抗指数(HOMA-IR)、胰岛素分泌指数(HOMA-B)、30min净增胰岛素与葡萄糖的比值(ΔI30/ΔG30)、糖负荷180min后胰岛素曲线下面积(AUC180)。结果患者经罗格列酮和赖脯25胰岛素治疗半个月后,空腹和餐后2h血糖及HOMA-IR显著降低,而HOMA-B、ΔI30/ΔG30和AUC180均较治疗前显著增高(均P<0.01)。结论罗格列酮和赖脯25胰岛素联合治疗初诊2型糖尿病可有效降低血糖,并能减轻胰岛素抵抗,同时恢复早期时相胰岛素的分泌。
Objective To investigate the recovery of pancreatic β-cell function in patients with newly diagnosed type 2 diabetes treated with rosiglitazone and insulin-25. Methods Fifty-six patients with newly diagnosed type 2 diabetes mellitus were treated with rosiglitazone and insulin lispro 25 for half a month before oral glucose-insulin test (OGIRT). Blood glucose and insulin were measured at each time point to calculate the index of insulin resistance (HOMA-IR), insulin secretion index (HOMA-B), net insulin-to-glucose ratio (ΔI30 / ΔG30) at 30 minutes and area under the insulin curve (AUC180) after 180 minutes of glucose load. Results After half a month treatment with rosiglitazone and insulin lispro 25, the fasting and postprandial plasma glucose and HOMA-IR at 2h were significantly decreased, while those of HOMA-B, ΔI30 / ΔG30 and AUC180 were significantly higher than those before treatment <0.01). Conclusions Rosiglitazone and 25R insulin combined treatment of newly diagnosed type 2 diabetes mellitus can effectively reduce blood glucose, reduce insulin resistance and restore early phase insulin secretion.