Study Of Effect Of Insulin Versus Glibenclamide On β-cell Function And Metabolic Control In Recently Diagnosed Type 2 Diabetes Patients

Objective:Study the effect of early insulin treatment and oral Glibenclamide on glycemic control and pancreaticβ- cell function in recently diagnosed type 2 diabetes mellitus.Methods:Forty-six patients recently diagnosed as type 2 diabetes mellitus with fasting plasma glucose(FPG)of 8-12mmol/L and glycosylated hemoglobin(HbA₁c)≥8.0%were randomly divided into three groups:group CSâ…¡,group MDI and glibenclamide-treated group.The patients were first treated and then waited for their glycemia for each patient was steady in a certain range.Then glycemic control,body mass index(BMI),the mean area under the curve of insulin(AUC),HOMA-βcalculated from the steady-state model and HOMA-IR of three groups were analyzed and compared between 3 groups at the time when glycemia was steady and at the time for the follow-up after six month.Measurement data were expressed with mean±standard deviation;the comparison of indexes between three groups was analyzed using single-factor analysis of variance,and the comparison of indexes in each group was analyzed using multi-factor analysis of variance.All statistical analyses were calculated with software SPSS11.5,and statistical significance was established when P＜0.05.Results:Comparing FPG of group CSâ…¡with that of group MDI,it was not statistically significant;however,FPG of glibenclamide group was significantly increased comparing with those of groups CSâ…¡and MDI after standard blood glucose control and follow-up of six months later(P＜0.05).Following treatment and follow-up of six months later,BMI of three groups were all significantly increased,respectively,comparing with BMI before therapy (P＜0.05).There was no statistical significance in BMI of three groups between standard blood glucose control and follow-up of six months later.Following treatment and follow-up of six months later,HOMA-βand AUC of three groups were all significantly increased comparing with that before therapy,respectively,(P＜0.01).There was no statistically significance in HOMA-βand AUC of group CSâ…¡and group MDI between standard blood glucose control and follow-up of six months later.Comparing with group CSâ…¡and group MDI,HOMA-βand AUC of glibenclamide-treated group were all significantly decreased following treatment(P＜0.05),and they were significantly increased comparing with that in follow-up of six months later(P＜0.05). Following treatment and follow-up of six months later,HOMA-IR of three groups were not significantly different comparing with that before therapy. Conclusion:The role of improving pancreaticβ- cell function of newly diagnosed type 2 diabetics mellitus of insulin therapy was more prominent and durable than that of oral glibenclamide therapy,and it could make them return to the start-up phase of the natural course in time.Comparing with MDI treatment,CSâ…¡therapy could not only improve the second phase insulin secretion,but also improve basal insulin secretion.Insulin therapy did not induce insulin resistance,and there was no statistically significance in the increase of BMI between after insulin therapy and after oral glybenzcyclamide treatment.There was no significant increase in insulin resistance during the course of treatment.