Factors Associated With ? Cell Function And Changes Of ? Cell Function Along With Duration Of Diabetes Among Patients With Type 2 Diabetes

Objective:The aim of the multicenter study was to analyze changes of ? cell function along with duration of diabetes and the association between hypoglycemic agents,antihypertensive drugs,lifestyle factors and P cell function among patients with type 2 diabetes.Homeostasis Model Assessment of Beta Cell Function(HOMA-?)was used to evaluate p cell function.Methods:From April 2016 to November 2016,patients were enrolled from endocrinology department of Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine,1st Affiliated Hospital of He'nan University of Science and Technology,Shanxi Provincial People's Hospital and West China Hospital,Sichuan University.Self-designed case report form was applied to collect data including general information,disease situation,therapy,laboratory examination,blood glucose records in hospital and inpatient's information.Results:4815 patients were enrolled in the present study,1692 patients were from Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine.781 patients were from 1st Affiliated Hospital of He'nan University of Science and Technology.1757 patients were from Shanxi Provincial People's Hospital and 585 were from West China Hospital,Sichuan University.The mean age of the sample was 49.There were significant differences in fasting serum insulin(FINS),HOMA-?,fasting blood glucose and 120 min blood glucose in patients with different durations of diabetes(P<0.001).Along with prolonging of duration,FINS and HOMA-(3 decreased(P<0.001,P=0.002)while blood glucose and 120 min blood glucose increased(P<0.001).Take patients whose diabetes duration<1 year as reference,when the duration of diabetes reached 10 years and 19 years,? cell function decreased by 13.32%and 37.91%(P<0.001)with a 2%annual rate of decline.Adjusting for age,duration of diabetes,body mass index(BMI),glycosylated hemoglobin A1c(HbA1c)in regression analysis,sulfonylureas,Dipeptidyl peptidase-4(DPP-4)inhibitors,Angiotensin II receptor antagonist(ARB)affected ? cell function(P=0.002,P=0.008,P=0.034,respectively)and heavy drinking did not influent ? cell function(P=0.363).Adjusting for duration of diabetes,BMI,HbA1c in regression analysis,smoking resulted in decreased ? cell function(P=0.035).Conclusions:1.With the development of the duration of diabetes,? cell function in patients with type 2 diabetes decreased with a 2%annual rate.2.Longer duration of diabetes lead to higher levels of fasting blood glucose and 120 min blood glucose.3.Sulfonylureas increased ? cell function deterioration while DPP-4 inhibitors improved p cell function in hypoglycemic agents.4.In antihypertensive drugs,ARB had positive effects on ? cell function.5.Smoking lead to ? cell function decline,it is recommended that type 2 diabetes patients should take a reasonable way to quit smoking to reduce damages of nicotine on ? cell function.6.The effect of heavy drinking on pancreatic ?-cell function was not statistically significant,but the downward trend could not be neglected.According to this result,heavy drinking did not been recommended.