Observation And Research On The Changes Of Threshold Of Tolerance Of Blood Glucose In The Diabetic Patients

Type 2 diabetes has become a global non-communicable diseases and endanger human health and to society, families, and patients with a heavy financial burden, strict control of blood glucose, slow the occurrence of complications of diabetes without delay. Of newly diagnosed type 2 diabetic patients with intensive insulin therapy are able to remove high glucose toxicity, improveβ-cell function, but the process of intensive therapy in patients with influenza tend to be hungry and / or palpitation, sweating, dizziness and other symptoms, but at this time blood glucose not less than 2.8mmol / L, should be concerned about the health care workers.Objective:To study the normal population with newly diagnosed type 2 diabetic patients with hypoglycemia insulin response before and after treatment, that is, hunger with / without palpitation, dizziness and other symptoms and the blood sugar level of blood glucose and glycosylated hemoglobin values to guide the relationship between intensive insulin therapy.Subject and Methods:A group: the normal people who feel the hungry (without DM and not fat). B group: the people come from Jilin University First Clinical Hospital. All of them coincidence the diagnosis of type 2 diabetes mellitus accorded with the new diagnostic criteria of WHO in 1999. At the same time, they must never get the treatment before. And without any diease which could make the blood glucose higher than the normal level. C group: the patients of B group who have the good control of blood glucose because they use the short-term insulin intensive treatment (their blood glucose of empty stomach<6.1mmol/L, their random blood glucose <8.0mmol/L).Criteria of diagnosis: (1) The diagnosis of type 2 diabetes mellitus accorded with the new diagnostic criteria of WHO in 1999. FPG≥7.0mmol/L(126mg/L)or random blood glucose≥11.1mmol/L(200mg/L)or OGTT≥11.1(200mg/L). (2) the blood glucose denominator: blood glucose of empty stomach<6.1mmol/L, random blood glucose <8.0mmol/L. (3) The short-term insulin intensive treatment is: (1) diet: The quantity of heat proportional distribution occupies for the carbohydrate 55%-60%, fat 30%, protein 15%-20%, and prohibits alcohol, the no-smoking, the protosalt diet (the daily physical strength activity: Movement frequency and time for each week at least 150 minutes, one week movement 5 days, each time 30 minutes, and the movement intensity is the physical strength activity; the (3) insulin amount used is 0.4u·kg-1·d-1, every 3 days adjust one time, each time adjust the dosage according to the blood sugar level are 4 units.Observation target: (1) blood sugar of the A group when they are hungry. (2) blood sugar of the B group when they are hungry. (3) blood sugar of the C group when they are hungry but haven't the phenomenon of glycopenia.Method: (1) Uses the American Johnson glucometer (to give prompt adjustment). (2) glycosylated hemoglobin examination method: Uses highpressured liquid phase law completely automatic saccharification hemoglobin analyzer which Bio-Rad Corporation produces. Carries on statistics analysis using the SPSS13.0 statistics software, measures the data to use (?x±s) indicated that becomes the group design information two sample mean value comparison (A group with B group; B group with C group) applies the T-test (A group with B group of line two independent sample mean value T-test, B group with C group of line of pair sample mean value T-test); B group of blood sugar endures the threshold value and the glycosylated hemoglobin data during two variables the good straight line correlation analysis.Result:(1) A group with B group of line two independent sample mean value T-test *p<0.05, B group of with C group of line of pair sample mean value T-test **p<0.05, when diabetes group feeling hunger or not accompanied by dizziness, to be flustered, hypoglycemia reaction time and so on perspiration blood sugars are higher than when the normal group hunger obviously the blood sugar value; But after the diabetic strengthens the treatment blood sugar standards, presents when the hunger or not accompanied by dizziness, to be flustered, hypoglycemia reaction time and so on perspiration blood sugars to be lower than for the first time treat patient's blood sugar value obviously. (2) the blood sugar endures the threshold value and the glycosylated hemoglobin two variable straight line correlation analysis r =0.975,p<0.01, result both has the linear correlation.Conclusion:(1) the diabetic and the normal group blood sugar endure the threshold value difference to have statistics significance. The diabetic presents when the sense of hunger the blood sugar normal group is high. (2) the first diagnosis patient insulin strengthening treatment the blood sugar endures the threshold value difference to have statistics significance. Carries on the insulin strengthening treatment after the first diagnosis 2 diabetics, before presenting the sense of hunger and/or dizziness, is flustered, time the big perspiration blood sugar to treat, low. 3rd, the diabetic feels when the hunger the blood sugar and the saccharification hemoglobin existence relevance, showed highly glycosylated hemoglobin value big first diagnosis 2 diabetic its blood sugar endures the threshold value to be also high, namely presents the sense of hunger and/or is flustered, when the big perspiration, dizziness the blood sugar to be high.Enlightenment:If can control the diet, adapts gradually, eats food not on own initiative, causes the blood sugar to endure the threshold value gradually to reduce, (1) this will be helpful in prevents the diabetic to eat food excessive, causes obese, the insulin resistance aggravates risk; Because is helpful in prevents the sugar tolerance unusuality to eat food the progress is diabetes blindly effectively. (2) it is helpful for doctor and for the patient in the adjustment insulin amount used adjustment, then prevents when the patient presents the hunger reduces the insulin quantity blindly, may also prevent the patient and eats food because of the hunger to cause the blood sugar on own initiative to elevate, but the blind Canadian insulin quantity's bad circulation's occurrence, this will be helpful to the blood sugar adjustment. (3) endures the threshold value according to the blood sugar, falls the blood sugar gradually, reduces the blood sugar drifting scope, enhances diabetes' treatment result advantageously. (4) the long-term observation the blood sugar long-term standards, may prevent effectively diabetes complication the occurrence.