The Relationship Between Insulin Dose And Syndrome Of Traditional Chinese Medicine In Hospitalized Patients With Type2Diabetes

Objective:This study expect to investigate the relationship between the insulin dose and syndrome of Traditional Chinese Medicine in hospitalized patients with type2diabetes when blood glucose up to standard. And we also analysised the possible factors which affected the insulin dose of different syndromes.Methods:According to the inclusion and exclusion criteria, we selected the type2diabetes patients who were conformed with the condition, grouping with syndromes, and it includes31cases with yin deficiency and hotness syndrome,40cases with qi and yin deficiency syndrome,22cases with yin and yang deficiency syndrome. The treatment program of three groups were once-daily glargine at bedtime plus three times daily insulin aspart before meals. Recording insulin dose (total of insulin dose/body weight) of each patients when blood glucose up to standard. Meanwhile, we collected the general information, blood pressure, fasting plasma glucose(FPG), fasting insulin(FINS), glycosylated hemoglobinAlc(HbAlc), blood lipids and uric acid in patients. And insulin dose and the clinical indicators were compared among different syndromes of TCM.Results:1. Insulin dose in comparison among different syndromes:The insulin dose of different syndromes of TCM were significantly different (P<0.05). And according to yin deficiency and hotness syndrome, qi and yin deficiency syndrome, yin and yang deficiency syndrome showed a trend of gradual increase. The inslin dose of yin and yang deficiency group was obviously different compared with the other groups (P<0.05) But there was no significant difference between yin deficiency and hotness syndrome and qi and yin deficiency syndrome (P>0.05)2. comparison of clinical parameters among the different syndromes:(1) There was no significant difference among different syndromes about the ratio of gender, FPG and HbA1c (P>0.05)(2) Significant difference were at age and disease duration among the three groups (P<0.05). And both according to yin and yang deficiency syndrome, qi and yin deficiency syndrome, yin deficiency and hotness syndrome showed a trend of gradual decrease. Pairwise comparison:the disease duration was significant difference between each two groups (P<0.05). About age, yin and yang deficiency groups was obviously difference from the other groups (P<0.05), but there were no significant difference between other groups (P>0.05).(3) There were no significant difference at abdominal circumstance and body mass index(BMI) among the three groups (P>0.05), but according to yin and yang deficiency syndrome, yin deficiency and hotness syndrome, qi and yin deficiency syndrome showed a trend of gradual decrease. The P value of abdominal circumstance and BMI were0.059and0.123respectively, approaching to0.05.(4) No significant difference were found at systolic blood pressure, diastolic blood pressure,total cholesterol(TC), triglyceride(TG), high density lipoprotein-cholesterol(HDL-C), low density lipoprotein-cholesterol(LDL-C) and uric acid (P>0.05).a. No significant difference were found at systolic blood pressure and LDL-C, but they had a tendency, expressing as yin and yang deficiency syndrome>qi and yin deficiency syndrome> yin deficiency and hotness syndrome. The P value of the both were0.095and0.227respectively, both approaching to0.05. b. TC and uric acid were no significant difference among the three groups, but having a tendency:yin and yang deficiency syndrome>yin deficiency and hotness syndrome>qi and yin deficiency syndrome. The P value of the uric acid was0.195, approaching to0.05. But the P value of the TC was0.440, appearing larger, c. Diastolic blood pressure, TG and HDL-C were no significant difference among groups. Yin and yang deficiency group also have not maximum trends. d. The ratio of patients with hypertension among different syndromes was no significant difference, but the percentage of each groups expressed as yin and yang deficiency syndrome>qi and yin deficiency syndrome>yin deficiency and hotness syndrome, the P value was0.136, approaching to0.05.(5) No significant difference was found at Home-insulin resistance index (Home-IR) and Home-insulin secretion index (Home-IS) among the three groups (P>0.05), but showed a tendency, according to yin and yang deficiency syndrome, qi and yin deficiency syndrome, yin deficiency and hotness syndrome, Home-IR gradually decreased, while Home-IS increased.Conclusion:1. There was a correlation between insulin dose and the syndrome of TCM in hospitalized patients with type2diabetic when blood glucose up to standard. And the yin and yang deficiency syndrome have the highest insulin dose.2. Compared to other syndromes, the patients of yin and yang deficiency syndrome showed the older age, longer disease duration and the lower trend of insulin section, and more performance of insulin resistance tendency for high BMI, hypertension, high LDL-C hyperlipidemia and hyperuricemia.3. The large insulin dose of yin and yang deficiency syndrome maybe related to the poorer islet β-cell function and the heavier insulin resistance.