| Objective: Plasma fibrinogen levels elevated in patients with type 2 diabetes,is one of features of abnormal metabolism characterized as insulin resistance,and hyperinsulinemia.Insulin therapy in patients with type 2 diabetes is becoming a common practice for glucose control.Exogenous insulin might further increase the hyperinsulinemia due to insulin resistance,and might lead further increase in plasma fibrinogen.In order to study if insulin therapy would increase the level of plasma fibrinogen in patients with type 2 diabetes,a retrospective observation was carried out to see if patients who were treated with insulin for at least one month before hospitalization would be higher than those who were not on insulin.Method: A total of 1409 patients was hospitalized in the department of the author from July 2015 to July 2016.1008 patients with type 2 diabetes was included after excluding patients without diabetes,patient with type 1 diabetes,and conditions which might affect fibrinogen levels in diabetic patients.The clinical and lab data were retrieved and patients were grouped into insulin only group(INS),insulin with oral hypoglycemic agents group(INS+OAD),oral agents only group(OAD),and nontreatment group(NON).There were 291 cases(men 66.7%)in NON,399(men52.4%)in OAD,144(men 67.6%)in INS,and 174(men 62.1%)in INS+OAD.Age,sex,height,weight,duration of type 2 diabetes mellitus(DD),drug treatment before admission were collected,and laboratory data of fasting blood glucose(FPG),total cholesterol(Chol),triglyceride(TG),low density lipoprotein the cholesterol(LDL-c),high density lipoprotein cholesterol(HDL-c),glycosylated hemoglobin(Hb A1c),fasting C peptide(FCP),2 hour postprandial C peptide(2h CP)and fibrinogen(FIB)analyzed within 24 h after admission were retrieved.Body mass index(BMI)was caculated as weight(kg)/(the height(meter))2.Statistical analysis was performed by using SPSS software(ver 19,IMB,USA)to compare the levels of FIB in each group,and to analyze the effect of insulin treatment on FIB.Results:1.Comparison of clinical characterics among different treatment groupsPatients who received any treatments were older than patients received no treatment(NON)(P < 0.05),and there was no difference in age among patients among the tree treatment group(P>0.05).Duration of diabetes were significantly different among all the study group(P<0.05),NON was 2.59 ±3.34 years,OAD 7.52 ± 6.77 years,INS 12.75 ± 7.32 years,and INS+OAD 12.69 ± 7.69 years.BMI was found only different between OAD and INS+OAD.The FPG and Hb A1 c were significantly higher in NON than in the other treatment groups,was lower INS than in OAD and INS+OAD,and no difference was found between INS and INS+OAD.FCP and 2h CP were lower in the two insulin treatment groups than in OAD and NON,thehighest levels were found in OAD,and no differences were found between the two insulin treatment groups.Chol and LDL-c was higher in OAD and INS+OAD than in NON and in INS.There were no significant differences for HDL-c among different groups.2.ANOVA showed that only FIB level(3.33 ± 0.88 g/L)in INS is higher than in NON(3.10 ± 0.69 g/L).No other differences were found among other treatment group(INS+OAS 3.21 ± 0.77 g/L,OAD 3.25± 0.82 g/L).General linear model analysis adjusted for age,gender,disease duration,and BMI,found no significant differences in FIB levels among the four groups(P > 0.05).Conclusion:Insulin treatment in patients with diabetes does not influence the plasma fibrinogen levels,and therefore,insulin therapy does not promote blood coagulation. |
PDF Full Text Request