Effects Of Intensive Insulin Therapy On Function Of Pancreatic β Cell In Type 2 Diabetes At Different Phages

OBJECTIVE:To investigate the changes ofβcell function in Type 2 diabetes at different phase after intensive insulin therapy.METHODS:we selected 21 newly diagnosed type 2 diabetes(group A) and 18 type 2 diabetes with secondary sulfonylureas failure(group B), and gave them short period intensive insulin therapy for 2 months.Oral glucose tolerance test and C-Peptide releasing test were performed for the patients in each group with 75 grams of glucose load,before and after intensive insulin therapy 2 weeks and 2 months.The level of blood glucose,C-Peptide and glycosylated hemoglobin(GHbAlc) were detected in each group before and after therapy 2 weeks and 2 months. Then we calculated insulin resistance index(HOMA-IR),pancreaticβcell index(HOMA-β),insulin secretion index(ΔC30/ΔG30),C-Peptide releasing area under curve(area under curve,AUC).RESULTS:Fasting,postprandial blood sugar and GHbAlc were Controled well by the therapy in each group.HOMA-IR and HOMA-βwere significantly improved in group A after intensive insulin therapy 2 weeks and 2 months,as compared with that before treatment;in group B,HOMA-IR was improved after therapy(P＜0.01),and HOMA-βwas improved after intensive insulin therapy 2 weeks and 2 months compared with that before treatment(P＜0.05);but HOMA-βafter therapy 2 months was improved insignificantly,as compared with that after 2 weeks.Insulin secretion index(ΔC30/ΔG30) in each group was significantly increased after earlier period of therapy,but it was not further significantly increased after therapy for 2 months.The area under curve of C-Peptide at 30,120minutes stimulated by glucose,was significantly increased after intensive insulin therapy(P＜0.05),as compared with that before treatment;Spatients in group A acquired a remission above halfa year which need not hypoglycemic agent.CONCLUSION:The sensitivity of insulin and the function of pancreaticβcell in newly diagnosed type 2 diabetes and diabetes with secondary sulfonylureas failure were significantly improved after intensive insulin therapy,but those were more obvious in newly diagnosed type 2 diabetes.The therapeutic efficacy could be obvious only after therapy for 2 weeks.