Huang Xuemei, Jiang Jiajin, Liu Li, Lin Yuanyuan, Zhang Feng, Ling Xiaoshan, Wei Haitao, Huang Guangjing, Ye Jinqun, Huang Cen, Huang Jianli, Tao Wenfu, Zou Xinyu
Department of Endocrinology, The First People's Hospital of Nanning, Nanning, Guangxi, China.
Department of Clinical Laboratory, The First People's Hospital of Nanning, Nanning, Guangxi, China.
J Diabetes Investig. 2025 Mar;16(3):426-433. doi: 10.1111/jdi.14371. Epub 2024 Nov 28.
AIM/INTRODUCTION: To evaluate the therapeutic efficacy short-term continuous subcutaneous insulin infusion (CSII) intensive therapy combined with a low-carbohydrate diet (LCD) for diabetes remission in patients with newly diagnosed type 2 diabetes mellitus.
This study included patients newly diagnosed with type 2 diabetes mellitus, who were randomly divided into two groups: conventional (conventional CSII + traditional lifestyle guidance); and intensive (intensive CSII + LCD lifestyle guidance). CSII was used for blood glucose control, with continuous glucose monitoring (CGM) used to monitor blood glucose levels. The primary outcome measure was hemoglobin A1c (HbA1c) level; secondary outcomes included body weight, body mass index (BMI), waist circumference, glycemic control, and biochemical indices.
The time in range (TIR) in the intensive treatment group was greater than that in the conventional treatment group (P < 0.05). There was no significant difference in the incidence of hypoglycemia between the two groups (P > 0.05). Compared with the conventional treatment group, diabetes remission rates were significantly greater in the intensive treatment group (P < 0.05). In the intensive treatment group, fasting plasma glucose (FPG), HbA1c, Homeostasis Model assessment of Insulin Resistance (HOMA-IR), triglycerides (TG), low-density lipoprotein cholesterol (LDL-c), and changes in body weight, BMI, visceral fat area (VFA), and subcutaneous fat area (SFA) decreased significantly (P < 0.05). FPG, HOMA-IR, TG, LDL-c, and changes in body weight, BMI, waist circumference, and VFA were significantly correlated with HbA1c levels (P < 0.05).
The combination of intensive CSII and LCD lifestyle guidance had been improved the remission rate in patients with newly diagnosed type 2 diabetes mellitus.
目的/引言：评估短期持续皮下胰岛素输注（CSII）强化治疗联合低碳水化合物饮食（LCD）对新诊断2型糖尿病患者糖尿病缓解的治疗效果。
本研究纳入新诊断的2型糖尿病患者，随机分为两组：传统组（传统CSII + 传统生活方式指导）；强化组（强化CSII + LCD生活方式指导）。使用CSII控制血糖，采用持续葡萄糖监测（CGM）监测血糖水平。主要结局指标为糖化血红蛋白（HbA1c）水平；次要结局包括体重、体重指数（BMI）、腰围、血糖控制和生化指标。
强化治疗组的血糖达标时间（TIR）高于传统治疗组（P < 0.05）。两组低血糖发生率无显著差异（P > 0.05）。与传统治疗组相比，强化治疗组的糖尿病缓解率显著更高（P < 0.05）。强化治疗组的空腹血糖（FPG）、HbA1c、胰岛素抵抗稳态模型评估（HOMA-IR）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-c）以及体重、BMI、内脏脂肪面积（VFA）和皮下脂肪面积（SFA）的变化均显著降低（P < 0.05）。FPG、HOMA-IR、TG、LDL-c以及体重、BMI、腰围和VFA的变化与HbA1c水平显著相关（P < 0.05）。
强化CSII与LCD生活方式指导相结合提高了新诊断2型糖尿病患者的缓解率。
