睡前胰岛素治疗可使静息能量消耗早期减少。

Early decrease in resting energy expenditure with bedtime insulin therapy.

机构信息

hôpital Haut-Lévêque, CHU de Bordeaux, Pessac, France.

出版信息

Diabetes Metab. 2009 Sep;35(4):332-5. doi: 10.1016/j.diabet.2009.04.003. Epub 2009 Jul 8.

DOI:10.1016/j.diabet.2009.04.003

PMID:19589712

Abstract

AIMS

In type 2 diabetes (T2D), insulin-induced weight gain may stem from a reduction in resting energy expenditure (REE). We sought to determine the early effects of insulin introduction on REE in 20 poorly controlled T2D patients.

METHODS

After improving the glycaemia, REE was measured on Day 0 and Day 4 during two treatment regimens: bedtime insulin (n=10, group 1); and one off (3-day) intravenous insulin infusion (n=10, group 2).

RESULTS

Both groups were similar in age, gender, BMI, C-peptide, HbA(1c) and initial REE. By Day 4, fasting glycaemia had similarly improved in both groups: group 1: -5.3+/-2.7mmol/L vs group 2: -5.8+/-4.2 mmol/L. In group 2, the second REE was measured 12h after stopping the intravenous insulin infusion, whereas subcutaneous insulin was maintained in group 1. REE did not change in group 2 (-1.3+/-6.5%), whereas it decreased significantly in group 1 (-8.0+/-7.0%; P<0.05).

CONCLUSION

Bedtime insulin led to an early and specific reduction in REE.

摘要

目的

在 2 型糖尿病（T2D）中，胰岛素引起的体重增加可能源于静息能量消耗（REE）的减少。我们旨在确定胰岛素引入对 20 例血糖控制不佳的 T2D 患者 REE 的早期影响。

方法

在改善血糖后，在两种治疗方案下于第 0 天和第 4 天测量 REE：睡前胰岛素（n=10，组 1）；和一次性（3 天）静脉内胰岛素输注（n=10，组 2）。

结果

两组在年龄、性别、BMI、C 肽、HbA（1c）和初始 REE 方面相似。到第 4 天，两组的空腹血糖均有类似改善：组 1：-5.3+/-2.7mmol/L 与组 2：-5.8+/-4.2mmol/L。在组 2 中，第二次 REE 是在停止静脉内胰岛素输注后 12 小时测量的，而组 1 中继续皮下注射胰岛素。组 2 的 REE 没有变化（-1.3+/-6.5%），而组 1 的 REE 则显著下降（-8.0+/-7.0%；P<0.05）。