【摘要】 目的 通过胰岛素短期干预，研究在体情况下胰岛素对胰岛β细胞早期分泌功能的影响，揭示不同病程中胰岛素的旁分泌刺激效应规律。方法 75例入选者分为正常组、IGT组、临床糖尿病组，后者又分为糖尿病无并发症组即DM-N组和有并发症组即DM-Y组。2型糖尿病患者先经过胰岛素干预治疗，然后所有入选者作OGTT和IRT，测定血浆葡萄糖、胰岛素、C肽、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、糖基化血红蛋白(HbA1c)。用稳态模型评估法评价胰岛素抵抗及胰岛β细胞功能，并计算胰岛素早期分泌指数(△I30/△G30)和OGTT各时点胰岛素曲线下面积(AUCI)。结果 病程早期，胰岛素作用下增加了空腹胰岛素分泌水平，随病情发展，不能逆转空腹胰岛素水平的下降趋势。结论 β细胞发生自身胰岛素抵抗可以导致胰岛素分泌减少。

    【关键词】 胰岛素；糖尿病，2型；胰岛

    【Abstract】 Objective To study the effect of insulin on the early secretion function of pancreatic beta-cell By short term intervening of insulin in vitro,as well as to probe into the law of side secretion effect in different stage of this disease.Methods 75 subjects were divided into normal,IGT or clinic diabetic groups.The latter included 2 sub-groups as follows:secondary complications and no secondary complication group.The type 2 diabetic patients were intervened by insulin,then all subjects underwent OGTT and IRT determine serum glucose,insulin and C peptide,total cholesterol(TC),high density lipoprotein-C(HDL-C),low density lipoprotein-C(LDL-C),triglyceride(TG),HbA1c.Homeostasis model assessment(HOMA) was applied to estimate insulin resistance(IR) and panreatic islet B cell function.The early insulin secret index(△I30/△G30) and the area under curve of insulin at all OGTT times(AUCI) were calculated .Results Insulin stimulated B cell to secrete insulin in the early stage of the disease,but did not reverse the downtrend of limosis insulin.Conclusion The insulin resistance of B cell will result in decrease of secretion. ......