The Effect Of Glucagon-like Peptide-1 On Early Type 2 Diabetic Patients Plasma Insulin And Blood Pressure

Objective:To investigate the effect of Glucagon-like Peptide-1 therapy on plasma insulin level and blood pressure by Collecting and analyzing the General clinical data, biochemistry parameters of early type 2 diabetes before and after treatment of Glucagon-like Peptide-1. To investigate the effect of glucagon-like peptide-l(GLP-1) on the other three factors,including insulin resistance,hypertension and angiotensin II and to guide clinical treatment, the clinical data of early type 2 diabetes patients treated with GLP-1 was collected and analysed. Methods:Participants were recruited from the diabetes outpatient population of the Tianjin General Hospital and Tianjin Harbor Hospital in China.To be eligible, patients had to meet The diagnostic criteria of Diabetes which was made by the World Health Organization Expert Committee of diabetes in 1999. Finally, 60 outpatients were randomly recruited from June 2013 to October 2014. Measurements took place at baseline, 8 weeks and 12 weeks after the start of the study; Height 、weight、waistline、 and blood pressure were tested. At the same time, fasting blood glucose,post blood glucose,glycated hemoglobin,triglycerides,low density lipoprotein,cholesterol high density lipoprotein, CRP, insulin, renin, angiotensin II and aldosterone were also tested.According to the levels of angiotensin II, the patients were divided into two groups.Patients whose angiotensin II was greater than 100ng/L were included in the high angiotentin II group(group A),and the others were the normal angiotensin II(group B).After the 8 weeks and 12 weeks application of GLP-1,we collected the two groups ’ data of AGE、W、BMI、BP、FPG、PPG、HBA1C、TC、TG、HDL、LDL、CRP、Ang II、FINS、HOMA-IR and waistline.The data was analysed with SPSS18 statistical software. The statistical test data was expressed by( sx±).The Measurement data were compared by two samples T test,the Count data by chi square test and the relationship between the two variables by linear Pearson correlation analysis.Result: 1.Measurements of two groups before GLP-1 therapy No significant difference was found in the measurements(P>0.05),including W、BMI、BP、FPG、PPG、HBA1C、TG、TC、HDL、LDL、CRP、FINS、HOMA-IR and waist. Only Ang II was statistically different(P<0.05).2.Measurements of group A after the 8 weeks and 12 weeks application of GLP-1 All measurements,including AGE、W、BMI、BP、FPG、PPG、HBA1C、TG、LDL 、 CRP 、 Ang II 、 FINS 、 HOMA-IR and waistline,were statistically significant(P<0.05).3.Measurements of group B after the 8 weeks and 12 weeks application of GLP-1 All measurements were statistically significant(P<0.05).4. Measurements between A and B after 12 weeks application of GLP-1 The treatment results,including W、BMI、Waistline、 BP、FPG、PPG、HBA1C、TG 、 TC 、 HDL 、 LDL 、 CRP 、 FINS 、 HOMA-IR were not statistically significant(P<0.05).5. Measurements between A and B After Pearson correlation analysis, Ang II、HOMA-IR 、SBP and CRP were positively related.Conclusion: 1. In patients with early type 2 diabetes,GLP-1 treatment was effective in lowering the patients’ blood glucose, Hb A1 C, waistline, weight and BMI. After 12 weeks of treatment, there was a significant difference. GLP-1 dosage was 0.6 to 1.8 mg per day. For patients with type 2 diabetes, GLP-1 therapy can effectively reduce insulin secretion. After 12 weeks of treatment, insulin resistance index(HOMA-IR)was significantly reduced. For diabetes patients with hypertension, GLP-1 treatment can effectively improve the patients’ blood pressure.For patients whose angiotensin II were high( angiotensin II>100 ng /L),GLP-1 can effectively reduce the level of angiotensin II,which maybe related to RAS.For patients whose angiotensin II were normal( angiotensin II≤100 ng /L) can effectively improve the patients’ blood pressure which maybe related to other factors.2.By Pearson correlation analysis,Ang II and the other three indicators,including HOMAIR 、SBP and CRP,were positively related.