Study Of Serum IgM And Insulin Sensitivity In Correlation In Patients With Type2Diaberes

Objective:To investigate the relationship between different concentrations of serum IgM on insulin sensitivity and insulin dosage to control plasma glucose in patients with type2diabetes.Methods:249cases of type2diabetic inpatients according to different concentrations of serum IgM were divided into group Ⅰ (IgM was lower than the normal value, n=32), group Ⅲ (IgM normal range, n=184) and group Ⅲ (IgM higher than the normal value, n=33). Each patient’s height and weight were gotten, and their blood samples were collected for determination of blood glucose, insulin, C peptide, HbAlc, GAD-Ab, ICA, IAA. After insulin therapy for about2weeks, it repeated the above indexes again. All the data were statistically analyzed.Results:After treated with insulin, fasting plasma glucose was significantly decreased in each group (P<0.01, P<0.01, P<0.05), and postprandial glucose was lowered significantly also in each group (all P<0.01); the amplitude of variation of postprandial blood glucose in group Ⅲ decreased significantly less than groups Ⅰ and Ⅱ (all P<0.01). Fasting insulin levels were increased in each group, and significantly elevated in groups Ⅱ and Ⅲ (all P<0.05), the changes of degree in groups Ⅱ and Ⅲ increased more greatly than in group Ⅰ. Insulin levels were elevated after meal in each group (P<0.05, P<0.01, P<0.01), group Ⅲ increased more greatly than groups Ⅰ and Ⅱ (all P<0.01). Index of HOMA-IR decreased in group Ⅰ, slightly rose in group Ⅱ, and increased obviously in group Ⅲ (P<0.01), the change of value in group Ⅲ was significantly larger than of in groups Ⅰ and Ⅱ (all P<0.01). Therefore, insulin dosage per day of group Ⅲ was significantly greater than group Ⅰ and Ⅱ (all P<0.01). There was a positive correlation between the serum IgM concentration and change of index of HOMA-IR (r=0.231;P=00001).Conclusion:1. Along with the elevation of concentration of serum IgM, plasma glucose control was not easy, serum insulin level was gradually increased, and HOMA-IR index increased also, in order to make the blood glucose control, exogenous insulin doses required higher daily;2.Serum IgM concentrations and change of index of HOMA-IR had positive correlation (r=0.231; P=0.00001).