Different Blood Glucose Levels On The Body Of The Preliminary Study

Background:Since the 1970s, A large number of epidemiological investigations about diabetic's best blood sugar control have been conducted,DCCT study, VADT, UKPDS or ADVANCE study, encouraging results have been brought to people---The more close to normal blood sugar control,the more ben-efit to patients with diabetes.But for the improvement of macrovascular disease, such it as cardiov-ascular complications, no significant benefit.was seen only in ADVANCE study was observed that with lower glycated hemoglobin, large vessel disease may have a downward trend.The UKPDS study showed that the type 2 diabete medium patients who has good blood sugar control possibly in the long-term have a good benefit in the prevention of cardiovascular disease.Diabetic macrovascular disease is the main cause of death,About 80% of diabetes patients died of atherosclerosis of macrovascular complications.Since the strengthening control blood sugar is significant improvement for microvascular complications, so, More near-normal glucose control would improve macrovascular disease. To verify this,National Heart, Lung, and Blood Institute (NHLB I) National Institutes of Health (N IH) carried out the ACCORD study in 2005, ten thousand subjects join in the experiment, The levels of glycosylated hemoglobin were set the Intensive Gluc-ose Control group was less than 6%, the standard treatment group was 7%-7.9%. The trial is expected to be 8 years, However, in the first 3.5 years it had to be discontinued.Mortality in the Int-ensive Glucose Control group was higher in than the standard treatment group, The Statistical dif-ference between the two groups is significaut.(P=0.04)Similarly, another large clinical trial showed almost same results,J Am Coll Cardiol,2009, a large randomized controlled clinical study of 6 thousand diabetic patients with heart failure, The re-searchers found that low blood sugar control had group increased mortality, Glycemic control in patients with moderate levels of mortality in the lowest, Compared with other groups,the difference was statistically significant (P=0.001).Results above caused big sensation, people tried to explain the phenomenon, Insulin-Resistant Cardiomyopathy draws most attention, creatine kinase(CK),creatine kinase isoinenzyme(CK-MB),CK-MB/CK,Troponin (TnI) are commonly used clinical markers for myocardial damage, Glycated hemoglobin levels, insulin resistance level, Myocardial enzymes and the relationship between these indicators may help us to understand the different levels of blood glucose levels on the impact of myocardial. For prevention, intervention and appropriate treatment provide the clinical evidence.part oneObjective:To explore type 2 diabetes patients the different level glycosylated hemoglobin the relationship with CK, CK-MB, and CK-MB/CK.Methods:95 T2DM patients, aged 55-79 years, DM duration (8.4±3.3) years, BMI (24.3±3.3) kg/m2, into three groups according to HbAlc level, A group (HbA1c< 6.4%) 34 cases, B group (7.0<HbAlc< 7.8%) 27 cases, C group (HbA1c≥9.0%) 34 cases. Comparison of the three groups CK, CK-MB, CK-MB/CK level. Results:1. three groups of CK, CK-MB was no significant difference, B group CK-MB/CK the lowest ratio of three groups, with the C group were significantly different, p<0.05.2. three groups of age, disease duration, BMI, cholesterol, triglycerides, high density lipoprotein, no significant difference; low-density lipoprotein are differences between groups, p<0.05.Conclusion:Type 2 diabetes when 7.0<HbA1c≤7.8%, CK-MB/CK was lowest, suggesting that the level of HbAlc in this state, there may be minimal myocardial damage.Part twoObjective:To investigate the type 2 diabetic patients the different level glycosylated hemoglobin the relationship with CK, CK-MB, and CK-MB/CK troponinⅠ, and insulin resistance.Methods:168 T2DM patients, aged 55 to 65 years, DM duration (9.1±2.4) years, BMI (24.5±3.3) kg/m2, into three groups according to HbA1c level, A group (HbAlc< 6.4%) 56 cases, B group (7.1<HbA1c≤7.8%) 56 cases, C group (HbAlc≥9.0%) 56 cases, detected three groups of CK, CK-MB, CK-MB/CK, troponin I, insulin resistance index (IR), blood lipids, uric acid and blood pres-sure. Comparison of group B insulin resistance (IR) and CK, CK-MB, CK-MB/CK relevance. Retest three months after the group B 27 patients with diabetes, hypoglycemic programs contain insulin sensitizer than pioglitazone 15-45mg,1/day, Nine patients with HbA1c maintained at 7.1-7.8%, and compared Before and after treatment IR, CK-MB, CK, CK-MB/CK, troponin I levels and blood lipid level.Results:1. three groups of CK, CK-MB was no significant difference, B group CK-MB/CK the lowest ratio of three groups, with the C group were significantly different, p<0.05; troponin I-positive rate of group A 32.1% B group 30.5%, C group 37.5%, no significant difference, p value is greater than 0.05.2. three groups of insulin resistance index were significantly different, A was lowest, and B, C group was statistically significant, p<0.05.3. two groups of insulin resistance index were significantly different, p<0.05.4. two groups of CK, CK-MB, CK-MB/CK ratio, troponin I,no significant difference. p> 0.05.Conclusion:Type 2 diabetes when 7.0<HbAlc< 7.8% in the three groups the CK-MB/CK was lowest, suggesting that the level of HbAlc in this state, there may be minimal myocardial damage; In this study we did not find Correlation between IR with CK, CK-MB, CK-MB/CK, troponin I, suggesting that the impact of glucose on myocardial may be far greater than the impact of IR on cardiac.