To Explore The Differences Of Islet ?-cell Function Between Type 2 Diabetic Ketosis Patients And Nonketotic Patients

Objective: To compare the differences of islet ?-cell function between type2 diabetic ketosis patients and nonketotic patients.Methods: The patients with type 2 diabetes mellitus who were hospitalized at the First Affiliated Hospital of Guangxi Medical University from June 2012 to December 2016 were selected as the subjects.Those type 2 diabetes patients are in line with the 1999 diagnostic criteria for the diagnosis of diabetes,and without metabolic acidosis,hypertonic status,hunger,infection,surgery,trauma and so on,and except for type 1 diabetes,gestational diabetes and other special types of diabetes.A total of 132 patients with type 2 diabetes were eligible for these criteria,according to whether the Urine ketone or blood ketone body was positive,those patients were divided into nonketotic group and ketosis group,among them,62 cases of nonketotic group,70 cases of ketosis group.Measured and recorded general conditions such as gender,age,height,weight,glycosylated serum protein,glycosylated hemoglobin,blood lipids,to treat with insulin and drugs during hospitalization.With the goal of 4.4<FPG<7.0mmol/L,2h PG<10.0mmol/L,when urine ketone or blood ketone turned into negative,did the oral glucose tolerance test and C-peptide release test,calculated HOMA-IR and HOMA-?,also area under the curve of plasma glucose and c-peptide.Results:1.Glycosylated hemoglobin and glycosylated serum protein of ketotic group were more higher(P<0.01).2.Total cholesterol,triglycerides of ketotic group were more higher(P<0.05).High-density lipoprotein cholesterol and low-density lipoprotein cholesterol of two groups were no significant difference(P>0.05).3.FPG and 30 min PG of two groups were no significant difference(P>0.05).60 min PG,120 min PG and 180 min PG of ketotic group were more higher(P<0.05).PG-AUC of ketotic group was more greater(P<0.05).4.FCP,30 minCP,60min CP and 120 min CP of nonketotic group were more higher(P<0.01).180 min CP of two groups were no significant difference(P>0.05).The CP-AUC value of the nonketotic group was greater than that of the ketotic group(P<0.05).The summit of C-peptide in the nonketotic group was at 180 min point even more later while ketotic group at 120 min.5.The HOMA-IR value of the ketotic group was higher than that of the nonketotic group(P<0.05),which means the insulin resistance of ketotic group was more obvious.HOMA-? in the nonketotic group was higher than that in the ketotic group,which means the secretion of islet ? cells in the ketotic group was weaker.Conclusion: Type 2 diabetic ketosis patients got worse pancreatic ?-cell function than non-ketone patients;Type 2 diabetic ketosis patients got more carbohydrate toxicity and lipid toxicity than non-ketone patients.