Study On The Effect Of Adpand Vaspin In Type 2 Diabetes Mellitus By Treatment Plan With Insulin Reduction As The Main Change

Objective:To study the effects of ADP and vaspin on type 2 diabetic patients by the blood glucose control scheme with insulin reduction based program,so as to guide the therapeutic dosage of insulin and provide a new theoretical basis for more safe and reasonable use of insulin.Methods:From January to December 2019,85 T2 DM patients were selected from the Department of Endocrinology,the First Affiliated Hospital of Hebei North University.(1)Analyze the statistical differences of related indexes between before and after insulin reduction,including fasting plasma glucose(FPG),exogenous insulin,fasting insulin,fasting insulin(FINS),C-peptide,body mass index(BMI),homeostasis model assessment insulin resistance(HOMA-IR),homeostasis model assessment β cell function(HOMA-β),ADP and Vaspin;(2)Group patients according to the degree of insulin reduction,Group A: insulin reduction degree ≥ 70%;group B: insulin reduction degree 30% ～ 69%,then,indexes were statistically analyzed between groups and within groups;(3)Finally,correlation and multifactor analysis of ADP,Vaspin and some indexes,including age,BMI,course of disease,C peptide,FPG,Hb A1 c,exogenous insulin,FINS,HOMA-IR and HOMA-β.All data are processed by SPSS25.0,and the legend is drawn by graph pad prism 8.0.Results:(1)After insulin reduction exogenous insulin,FPG,HOMA-IR,Vaspin decreased and the difference was statistically significant(P<0.05),C-peptide,HOMA-β,ADP increased and the difference was statisticallysignificant(P<0.05);(2)After insulin reduction between groups A and B,C-peptide in group A was higher than group B and the difference was statistically significant(P<0.05).In group A,ADP and Vaspin were significantly higher after insulin reduction than before(P<0.05),there was no significant difference in ADP and Vaspin after insulin reduction than before in group B(P>0.05);(3)correlation analysis between ADP,Vaspin and clinical indicators,ADP and BMI,exogenous insulin,fins,HOMA-IR were negatively correlated,the difference was statistically significant(P<0.05);Vaspin and FPG,HOMA-IR were positively correlated,the difference was statistically significant(P<0.05).ADP multiple linear regression was carried out,BMI and HOMA-IR entered the model,and the regression equation was Y=3.824-0.008X1-0.021X2(X1 was HOMA-IR,X2 was BMI).Conclusion:(1)Insulin reduction as the main change of treatment plan in T2 DM patients,insulin resistance decreased and islet function improved after the decrease of insulin dosage,and the more the decrease of insulin dosage,the more endogenous insulin secretion;(2)The change of ADP level is related to insulin dosage and decrease degree,which is considered to be related to insulin related effect,and the level of ADP will increase with the increase of insulin resistance and BMI;(3)The degree of insulin resistance and the level of blood glucose are part of the influencing factors of Vaspin.