Weight Management In Type 2 Diabetes Treatment Strategy Of Great Significance

Objective:Investigate the important meaning of weight management in type2diabetes mellitus treatment strategy. With the rapid development of modern society, people have changed their eating habits and the incidences of obesity and type2diabetes mellitus are on the rise. As there is a close connection between them, understanding the significance of weight management in type2diabetes mellitus treatment can provide firsthand data for clinical work.Methods:1308patients diagnosed with stype2diabetes mellitus in the Endocrine in-patient department of the China-Japan Friendship Hospital from January2011to March2013are the subjects in this study. There are867male patients and441female patients whose average age is55.6+13.9and the average duration is10.3±7.33years. According to the2002China adult body mass index (BMI) classification criteria, we can divide the patients into4different levels, which are normal weight (BMI18.5～23.9) group (350cases), being overweight (BMI of24-27.9) group (562cases), I degree of obese (BMI28～29.9) group (210cases), II degree obese (BMI of30or higher) group (186cases). Patients who is thin (BMI<18.5), or has acute stress conditions such as fever, infection, pain, diarrhea, or acute complications of diabetes (ketoacidosis, hyperosmolar non-ketotic hyperglycemic coma, lactic acidosis), and other serious diseases are excluded. Collect relevant medical history, clinical data of the patients, store these data with Excel, and analyze with SAS9.0software. Continuous variables are shown as mean+standard. Logarithmic transformation was applied for the data in linear regression analysis because of not being normally distributed. The mean differences were analyzed by analysis of variance. The ratio differences were tested by χ2test. Degree of association between continuous variables was evaluated with Pearson simple correlation analysis.Results:①In1308cases of patients, the distribution proportion of normal weight, overweight, obesity and II degrees obesity group was27%,43%,16%,43%. The proportion of new clinic patients in each group showed no obvious differences, so each group had good comparability. ②The average age of II degree obese group was lower than the other3groups. There was no differences between overweight and I degree of obesity about the average age, which however was lower than the normal weight group (P<0.05). The four groups had no differences about the duration(P<0.05). The BMI and WC of the four groups were different (P <0.05). SBP of the I and II degree obese groups had no obvious differences which however was higher than the former two groups. DBP of the II degree obese group was higher than those of the other groups; DBP of the overweight and I degree obese groups had no differences, which however was higher than that of the normal weight group (P<0.05). TG in I and II degree obesity groups showd no obvious differences, but was significantly higher than those of the former two groups. TG in overweight was higher than that of the normal weight group (all P<0.05). HDL-C in II degree obese group was lower than those of the other groups. There showd no differences between overweight and I degree obese group, which however was lower than that of the normal weight group (all P<0.05). TC and LDL-C showd no differences between the4groups (P<0.05). UA in the Ⅱ obese group was significantly higher than those of the other groups; there was no differences between overweight and I degree obese group, which however was higher than normal weight group (P<0.05). CRP in II degree obese group was significantly higher than those of the other groups (P<0.05). ACR in II degree obese group was significantly higher than those of the other groups (P<0.05).③0.5PG in I degree obese group、1hPG in overweight and I degree obese group and2hPG in normal weight、overweight and I degree obese group were higher than those of the II degree obese group. The rest of the blood glucose and HbAlc had no differences in the four groups (P>0.05). The CP levels increased with BMI increased (P<0.05).The HOMA-β and HOMA-IR were difference in the four groups, which increased with BMI(P<0.05).④Patients hospitalized because of the ketosis were divided into normal weight and overweight or obesity group. These two groups had the same proportion of the new diagnosed patients and the confirmed patients. The average age of overweight and obese group was obviously lower than that of the normal weight group, but the HOMA-β and the HOMA-IR were significantly higher than the latter (all P<0.05). ⑤In different BMI groups, the distribution of hypertension and dyslipidemia increases with BMI, which was statistically significant (x2were54.8894and27.1749, all p<0.0001). Diabetic retinopathy distribution proportion in different BMI groups had no statistically significant differences (x2=1.7624, p=1.7624); Diabetic nephropathy distribution proportion increased significantly in the II degree obeses group, which has statistical significances (x2=8.9382, p=0.0301). In different BMI groups, the distribution of the peripheral atherosclerosis obliterations increased while BMI decreased and this had statistical differences (x2=7.8886, p=0.0484); The distribution of coronary heart disease and stroke showed no statistically significant differences (x2was4.6489and4.6489, p were0.1994and0.6798). In different BMI groups, the distribution of the insulin injections increased while BMI decreases and this has statistically differences (chi-square=8.5887, p=0.0353).⑥BMI was positively correlated with WC、SBP、DBP、UA、TG、CRP、 FCP.0.5HCP、1hCP、2hCP、the HOMA-β and the HOMA-IR and was significant negative correlated with age、HDL-C and HbAlc. Conclusions:①Patients with normal-weight has higher degree of the destruction of pancreatic β cells than the patients who are overweight or obese,but has a lighter degree of the insulin resistance. However choose the treatment strategy should fully consider the above characteristics.②Patients with type2diabetes, who are overweight or obese, often have an increased incidence of cardiovascular disease (CVD) risk factors compared with patients whose weight are normal. The morbidities of coronary disease and stroke are equal between patients with type2diabetes who are overweight or obese and those with normal-weight when the patients are obviously young.③Weight control is conducive to synthetical achieved rate for type2diabetes patients who are overweight, which include blood sugar, blood pressure, blood fat, etc, which can also lower cardiovascular event and development of microangiopathy to improve the quality of the patient’s life.