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| Abstract |
To investigate the effects of short-term(1 week)intensive insulin therapy, on glycemic control, insulin secretion, and insulin sensitivity in type 2 diabetic patients, an open prospective study was co...nducted in sixteen type 2 diabetic patients receiving diet therapy alone or treatment with oral hypoglycemic agents. Of the study subjects, 8 patients were treated with insulin, the remaining 8 patients served as the control group. The metabolic parameters were evaluated once before treatment and once during one of the following treatments : glycemic control as measured by 1,5-anhydro-D-glucitol(1,5-AG)and area under curve of glucos (AUCgiucose),insulin secretion as measured by area under curve of daily serum insulin(AUCinsulin), and insulin sensitivity as measured by the K index of the insulin tolerance test(KiTT).Post-treatment plasma glucose(AUCgiucose) and 1,5-AG levels in patients who had received intensive insulin therapy were comparable to those of the control group. A statistically significant increase in AUCinsulin occurred after intensive insulin therapy for just 1 week, while no change occurred in the control group. Insulin sensitivity(KiTT) did not improve significantly in patients treated with insulin or patients from the control group. These results indicate that intensive insulin therapy for 1 week improves insulin secretion remarkably but has little effect on insulin sensitivity in type 2 diabetic patients. Clinically, this suggests that intensive insulin therapy for one week might be one of the initial treatments of choice for such patients.
2型糖尿病患者において, 1週間の短期インスリン強化療法による血糖コントロール, インスリン分泌能およびインスリン感受性の効果をみるため, 16名のインスリンを使用していない2型糖尿病患者を研究に供した. このうち8名には実際に1週間の短期インスリン強化療法を施行し, 残りの8名はインスリンを導入せず外来治療をそのまま入院中継続した. 血糖コントロールの指標には1,5-アンヒドログルシトール(1,5-AG)とAUCglucoseを, インスリン分泌能の指標にはAUCinsulin, インスリン感受性の指標にはKITTを用いた. 治療後のAUCgulcoseと1,5-AGは短期インスリン強化療法導入群と非導入群の問に有意差を認めなかったが,AUCinsulinについては, 短期インスリン強化療法群は非導入群と比較して著明に増加していた. KITTは両者の問に有意差は認めなかった. 以上の結果から1週間の短期インスリン強化療法でインスリン分泌能は著明に改善することが判明した. このことから臨床的に1週間の短期インスリン強化療法は血糖コントロールのために選択されるべき一つの治療法であると考えられた.show more
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