Department of Endocrinology and Metabolism, The Third People's Hospital of Chengdu, The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu 610031, China.
Department of Hematology, The Third People's Hospital of Chengdu, The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu 610031, China.
Diabetes Res Clin Pract. 2018 Apr;138:246-252. doi: 10.1016/j.diabres.2018.01.033. Epub 2018 Feb 3.
Early short-term intensive insulin therapy in newly diagnosed type 2 diabetes patients shows benefit in glycemic control and β-cell function. Glucagon-like peptide-1 (GLP-1) plays an important role in glucose metabolism and development of type 2 diabetes. We did a study to observe the changes of GLP-1 and β-cell function after short-term continuous subcutaneous insulin infusion (CSII) treatment.
A total of 66 subjects were enrolled, including 30 normal glucose tolerance controls (NGT) and 36 patients with newly diagnosed type 2 diabetes between October 2015 and July 2016. Fasting plasma glucose (FPG), insulin, and GLP-1 were measured in each subject. The patients underwent CSII treatment for 2 weeks, and then FBG, insulin, and GLP-1 were measured. HOMA-IR and HOMA-B were then calculated.
All patients achieved target glycemic control in two weeks. HOMA-IR and HOMA-B improved significantly after intensive interventions (p < 0.05). The GLP-1 concentration increased significantly in patients after treatment (p < 0.05). When grouped according to bodyweight and age in all patients, the HOMA-IR changed significantly in overweight and old age subgroups, the HOMA-B increased significantly in normal weight, overweight and middle age subgroups, and the GLP-1 concentration also increased significantly in overweight and middle age subgroups respectively (p < 0.05).
Short-term CSII treatment can obtain glycemic control target and recover β-cell function and GLP-1 secretion in newly diagnosed type 2 diabetes patients. The overweight and middle-aged patients may get more benefit from this treatment.
新诊断的 2 型糖尿病患者进行早期短期强化胰岛素治疗在血糖控制和β细胞功能方面显示出获益。胰高血糖素样肽-1(GLP-1)在葡萄糖代谢和 2 型糖尿病的发生发展中发挥重要作用。我们进行了一项研究,旨在观察短期持续皮下胰岛素输注(CSII)治疗后 GLP-1 和β细胞功能的变化。
共纳入 66 例受试者,包括 30 例正常糖耐量对照(NGT)和 2015 年 10 月至 2016 年 7 月期间新诊断的 36 例 2 型糖尿病患者。每位受试者均检测空腹血糖(FPG)、胰岛素和 GLP-1。患者接受 CSII 治疗 2 周,然后检测 FBG、胰岛素和 GLP-1,并计算 HOMA-IR 和 HOMA-B。
所有患者在 2 周内均达到目标血糖控制。强化干预后 HOMA-IR 和 HOMA-B 显著改善(p<0.05)。治疗后患者的 GLP-1 浓度显著升高(p<0.05)。在所有患者按体重和年龄分组后,超重和老年亚组的 HOMA-IR 变化显著,正常体重、超重和中年亚组的 HOMA-B 显著增加,超重和中年亚组的 GLP-1 浓度也显著增加(p<0.05)。
短期 CSII 治疗可使新诊断的 2 型糖尿病患者获得血糖控制目标,并恢复β细胞功能和 GLP-1 分泌。超重和中年患者可能从这种治疗中获益更多。