| Background:Type 2 diabetes mellitus(T2DM) is a common metabolic disease,which is a persistent hyperglycemia state due to genetic and environmental factors joint effects,and has become the third largest chronic uninfectious disease which threaten on human health seriously, only behind the cancer and cardiovascular diseases.Therefore, it is a urgent task to explore a reasonable treatment method for T2DM patients.Since The Diabetes Control and Complications Trial(DCCT, 1993) and The UK Prospective Diabetes Study(UKPDS, 1998) results showed,early intensive well-controlled glycemia can reduce and prevent sorts of diabetic chronic complications.Many following researches also further confirmed that early intensive well-controlled glycemia may improve isletβ-cell functions, reduce insulin resistance, and delay disease development. Our predecessors had done a great deal of work about early intensive glycemia-controlled.It is recommended that the new diagnosed T2DM patients use continue subcutaneous insulin injections (CSII) therapy for two weeks, but the associated documents data is few about how the isletβ-cell secretary function and the insulin resistance change dynamically in the two weeks.Objective To observe the influence of the short-term intensive therapy on plasma glucose andβ-cell function in newly diagnosed type 2 diabetes dynamically,as to explore the relationship between theβ-cell function recovery and the intensive insulin treatment time. Thirty patients were divided into three sub-groups,respectively from Age,BMI,HbA1c to explore the most profitable patients by CSII.Methods According to the WHO 1999 diabetic diagnostic criteria, thirty patients with newly diagnosed T2DM were treated by CSII about 2 weeks. Blood sugar was controlled within the standard which were FPG<7.0mmol/L and 2hPG<10.0mmol/L.Before treatment and the first day after glycemia well-controlled,the fifth day,the tenth day, Oral glucose tolerance test(OGTT) and C-peptide release test were performed respectively. C-p/PGAUC,Homaβ,HomaIR,FPG,2hPG were calculated, and the result of blood lipid were compared before and after CSII.In addition,the thirty patients were divided into three sub-groups,respectively from age(≥60yrs vs <60yrs),BMI(≥24 vs <24),HbA1c(≥10% vs <10%)to observe C-P/G AUC,Homaβ,HomaIR dynamic change,in order to further explore isletβ-cell function recovery degree in condition of different age,BMI,HbA1c.Results CSII intensive therapy showed rapid and stable glucose-lowering effect. The excellent control of FPG and 2hPG in thirty patients were achieved in 3.9±1.4days by CSII. Isletβ-cell secretary function was improved significantly,and was apparent on the first day after glycemia well-controlled(P<0.05).The total four C-P/PG AUC,Homaβbefore and after CSII therapy , had gradually increased with the treatment time extended,and there was a clear statistical significance. HomaIR declined markly than the data before treatment, the largest range was found on the first day after glycemia well-controlled,TC,TG also declined significantly. In sub-groups analysis, isletβ-cell function recovered better in the group of Age<60,BMI<24 and HbA1c≥10%.Only three patients had mild hypoglycemia, who showed hunger feeling. No serious adverse events happened, for example anaphylaxis,edema and so on.Conclusion For the newly diagnosed type 2 diabetes, the excellent glycemic control can be achieved rapidly and stably, andβ-cell function can be gradually improved and insulin resistance can be reduced by the short-term CSII intensive therapy. Besides, the treatment effect was more notable in the newly diagnosed T2DM who was age<60 or BMI<24 or HbA1c≥10%. |
