初诊 T2DM 患者短期胰岛素泵强化治疗后后续治疗方案选择.

Objective To explore the optimal subsequent therapeutic regimen for newly diagnosed patients with type 2 diabetes mellitus ( T2DM ) after short-term intensive insulin therapy with insulin pump. Methods Eighty-four newly diagnosed T2DM patients with up-to-standard blood glucose after short-term intensive insulin therapy with insulin pump were selected. They were randomly divided into the observation group and control group，with 42 cases in each group. Patients in the control group were administered oral hypoglycemic agents for subsequent treatment， while patients in the observation group received subcutaneous injection of basal insulin for subsequent treatment. The fasting blood glucose ( FBG )，glycosylated hemoglobin ( HbA1c ) and fasting C peptide ( FCP ) were detected before treatment and after 2-year follow-up. Moreover， the BMI， insulin secretion index ( HOAM-β ) and insulin resistance index ( HOAM-IR ) were calculated. Meanwhile， the carotid intima-media thickness ( IMT ) was detected on the same day，and the carotid plaque detection rate was also calculated. Results HbA1c and BMI in both groups after treatment were lower than those before treatment ( all P < 0. 05 )， but the differences after treatment between these two groups were not statistically significant ( all P > 0. 05 ). HOMA-IR in both groups after treatment was lower than that before treatment，while HOAM-β was higher than that before treatment，and the changes in the observation group were more significant ( all P < 0. 05 ). Carotid IMT in the control group after treatment was higher than that before treatment ( P < 0. 05 )，but the difference in the observation group before and after treatment was not statistically significant ( P > 0. 05 ). In addition， carotid IMT in the observation group after treatment was lower than that in the control group after treatment ( P < 0 . 05 ). Differences in carotid plaque detection rate between two groups before and after treatment were not statistically significant ( all P > 0 .05 ). Conclusion Subcutaneous insulin injection in newly diagnosed T2DM patients after short-term intensive insulin therapy with insulin pump is more effective in improving the pancreatic function than the subsequent treatment with oral hypoglycemic agents. [ABSTRACT FROM AUTHOR]