Kishikawa H, Taguchi T, Matsumoto K, Shichiri M
Department of Metabolic Medicine, Kumamoto University School of Medicine.
Nihon Rinsho. 1999 Mar;57(3):681-7.
DCCT and Kumamoto Study demonstrated that optimal glycemic control with intensive insulin therapy could delay the onset and progression of the early stages of diabetic microvascular complications in Japanese patients with noninsulin dependent diabetes as well as in patients with insulin dependent diabetes mellitus. To obtain optimal glycemic control, the prandial insulin supplements before each meal are recommended for insulin requiring patients with noninsulin dependent diabetes mellitus whose residual B cell functions are retained to some extent, whereas the combined basal at bedtime plus prandial insulin supplements are essential for the patients with noninsulin dependent diabetes mellitus whose residual B cell functions are severely exhausted as well as in the patients with insulin dependent diabetes mellitus. The glycemic threshold to prevent the onset and progression of diabetic microvascular complications in the Kumamoto Study was indicated as follows; HbA1c < 6.5%, fasting blood glucose concentration < 110 mg/dl, and 2-hour postprandial blood glucose concentration < 180 mg/dl.
糖尿病控制与并发症试验（DCCT）和熊本研究表明，强化胰岛素治疗实现最佳血糖控制，可延缓日本非胰岛素依赖型糖尿病患者以及胰岛素依赖型糖尿病患者糖尿病微血管并发症早期的发病和进展。为实现最佳血糖控制，对于仍保留一定残余B细胞功能的非胰岛素依赖型糖尿病胰岛素需求患者，建议在每餐之前补充餐时胰岛素，而对于残余B细胞功能严重衰竭的非胰岛素依赖型糖尿病患者以及胰岛素依赖型糖尿病患者，睡前基础胰岛素联合餐时胰岛素补充剂必不可少。熊本研究中预防糖尿病微血管并发症发病和进展的血糖阈值如下：糖化血红蛋白（HbA1c）<6.5%，空腹血糖浓度<110mg/dl，餐后2小时血糖浓度<180mg/dl。
