Effect Of Insulin Therapy On ?-cell Function Of Type 2 Diabetes

Objective:To analysis the effect of insulin therapy on ?-cell function of type 2 diabetes,in order to clarify the characteristics of ?-cell function of type 2 diabetes.Method:(1)1956 cases of T2DM(type 2 diabetes)during 2013-3 till 2014-9 were collected.(2)They underwent an oral glucose tolerance test.Testing the plasma insulin,C peptide and glucagon at 0min,30 min,1hour,2hour and 3hour.(3)Screening treatment duration>3 months under different treatment and their age,gender,Hb A1 c have no statistical difference,then calculated and compare each course,fasting,0-30 minutes AUC(Area Under the Curve),30-120 minutes AUC of insulin,C-peptide and glucagon.(4)According to the dose of insulin,divided the cases treated with insulin into three groups,calculated and compare each course,Hb A1 c,0-30 minutes AUC,30-120 minutes AUC of insulin,C-peptide and glucagon.Result:1.Using insulin group compared with using non insulin secretagogues group:Using insulin group had significantly longer course(p<0.05);it's plasma concentration of insulin was higher at fasting,AUC of 0-30 minutes,AUC of 30-120 minutes(p<0.05);it's plasma concentration of C-peptide was lower at fasting,AUC of 0-30 minutes,AUC of 30-120 minutes(p<0.05);it's plasma concentration of glucagon was lower at fasting,AUC of 0-30 minutes,AUC of 30-120 minutes(p<0.05).2.Using insulin group compared with using insulin secretagogues group: Using insulin group had significantly longer course(p<0.05);it's plasma concentration of insulin was higher at fasting,AUC of 0-30 minutes,AUC of 30-120 minutes(p<0.05);the plasma concentration of C-peptide and glucagon were lower.3.Using insulin combinated with non insulin secretagogues group compared with using non insulin secretagogues group:The combination group had significantly longer course(p<0.05);the plasma concentration of insulin was higher at fasting,AUC of 0-30 minutes(p<0.05);the plasma concentration of C-peptide was lower at fasting,AUC of 0-30 minutes(p<0.05);it's plasma concentration of glucagon was lower at fasting,AUC of 0-30 minutes,higher at AUC of 30-120 minutes.4.Using insulin combinated with insulin secretagogues group compared with using insulin secretagogues group: The combination group had significantly longer course(p<0.05);the plasma concentration of insulin was higher at fasting(p<0.05);the plasma concentration of C-peptide and glucagon in two group had no significantly difference.5.Comparison between different daily insulin doses groups(1)Compared with insulin?30IU group,30IU?insulin?50IU group had longer course(p<0.05),higher Hb A1 c,higher plasma concentration of insulin,lower plasma concentration of C-peptide and glucagon.(2)Compared with insulin?30IU group,insulin?50IU group had longer course(p<0.05),higher Hb A1c(p<0.05),higher plasma concentration of insulin,lower plasma concentration of C-peptide and glucagon.(3)Compared with 30IU?insulin?50IU group,insulin?50IU group had longer course,higher Hb A1 c,higher plasma concentration of insulin,the plasma concentration of C-peptide and glucagon in two group had no significantly difference.Conclusion:1.On the basis of no statistical difference on age,gender and Hb A1 c,using insulin groups had significantly longer course and higher plasma concentration of glucagon than using oral medicine groups.2.The plasma insulin levels were significantly affected by exogenous insulin.The ?-cell of using insulin groups secreted lower insulin.3.Comparison between different daily insulin doses groups,the larger doses of insulin,the longer course,the higher Hb A1 c.4.Comparison between different daily insulin doses groups,the larger doses of insulin,the lower insulin secreted by?-cell,the lower glucagon secreted by ?-cell.5.Insulin therapy might dose-dependently inhibit the secretion of glucagon.