| Objective To investigate the effects of compound probiotics(five live bacteria)combin ed with metformin on blood glucose,islet function and insulin resistance in patients w ith type 2 diabetes mellitus(Type 2 diabetes,T2DM).Methods Selected patients with T2DM who were treated in our hospital from March2019 to March 2021 with only oral metformin 1.5g/day,104 volunteers were selected as the study subjects,randomized,double-blind,and placebo(probiotics/placebo is 1:1)Controlled study.Before entering the group,the baseline data were collected and recor ded,including height,weight,waist circumference,blood pressure and body mass inde x((Body Mass Index,BMI).Fasting venous blood was collected to measure glycosylat ed hemoglobin(Hb A1c),fasting blood glucose and fasting insulin,blood lipids and uri c acid.Blood samples were collected 0.5h,1h,2h and 3h postprandial respectively after taking 100g standard flour steamed buns.Blood glucose and insulin were measur ed at each time point after meal.The patients were treated with compound live bacter ia/placebo plus metformin for 12 weeks,and the above indexes were re-examined at the end.The body weight,waist circumference,Hb A1c analysis before and after treat ment,isletβcell function index(homeostasis model assessment-β,HOMA-β),insuli n production index(the insulinogenic index,IGI(IGI0.5h,IGI1h),insulin resistance ind ex(homeostasis model assessment of insulin resistance,HOMA-IR),Gutt(ISI0120)inde x,QUICKI index,blood lipid related indexes and uric acid were compared and analyzed between the tw o groups before and after treatment.Results(1)6 patients in the probiotic group were lost to follow-up,and 18 patients in the placebo group were lost to follow-up;(2)Waist circumference(87.23±8.96)cm and BMI(26.52±1.94)kg/m2 in the probiotic group after treatment were significantly lower than those before treatment(91.99±9.94)cm and BMI(27.86±2.32)kg/m~2,(P<0.05);(3)The reduction of Hb A1c(6.33±0.18)%in the probiotic group after treatment was better than that in the placebo group(6.65±0.77),(P<0.05);(4)HOMA-β(52.69±14.25)in the probiotic group after treatment was higher than that before treatment(40.93±8.62),(P<0.05);HOMA-β(52.69±14.25)in the probiotic group after treatment was significantly higher than HOMA-β(44.37±9.08)in the placebo group,(P<0.05),after treatment in the probiotic group IGI0.5h 5.33(2.3,12.09)was significantly higher than IGI 0.5h 3.11(1.81,4.8)before treatment(P<0.05);(5)There was no significant difference in HOMA-IR,Gutt(ISI0,120)index,and QUICKI index between the two groups after treatment;(6)After treatment,the observation group and the control group triglycerides(TG),cholesterol(CHOL),low-density lipoprotein cholesterol(LDL-CH),high-density lipoprotein cholesterol(HDL-CH),two groups of apolipoprotein A1(APOA1),Apolipoprotein A1/Apolipoprotein B(APOA1/APOB),Apolipoprotein B(APOB)have no significant changes;(7)The level of uric acid in the probiotic group after treatment(354.63±21.26)was significantly lower than that before treatment(371.33±22.73),(P<0.05);and the decrease in uric acid in the probiotic group after treatment(354.63±21.26)was better than the placebo group(374.56±26.99),(P<0.05).Conclusion The compound probiotics(five live bacteria)can help reduce the waist cir cumference and BMI of patients with T2DM;it can also improve the function of pan creaticβ-cells;it can help enhance the hypoglycemic effect of metformin on patients with T2DM;it is conducive to the reduction of uric acid levels. |
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