| Objective: To survey the comprehensive analysis of the past 3 years in the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine Department of endocrinology in newly diagnosed type 2 diabetic patients and analyze its clinical characteristics,understanding from different angles of incidence of diabetes control,provided research ideas for the diagnosis,prevention and treatment of type 2 diabetes mellitus.Methods: the cases of inspection,through the period from January 1,2015 to December 31,2017 were hospitalized in the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Department of Endocrinology treatment,and for the first time the onset of a total of 98 cases of patients with type 2 diabetes,a detailed record of name,gender and age,occupation,height and weight,there is no index of onset,family history of diabetes and the reasons for admission,the clinical symptoms,fasting blood glucose,glucose tolerance test and insulin release test,insulin resistance index(HOMA-IR),insulin secretion function index(HOMA-?),glycosylated hemoglobin(Hb A1c),indicators of lipid metabolism(CHOL,TG,HDL,LDL),thyroid related indicators(T3,T4,TSH,Trab,Tgab),transaminase(ALT,AST)urinary albumin(MALB),creatinine(SCr),uric acid(UA),urine ketone(KET),glucose(GLU),treatment programs,discharge blood glucose levels and other data,The patients were grouped according to their admission reasons,gender,age,onset of ketone bodies,insulin treatmentand so on.Statistical analysis was performed by spss20.0 statistical software.Results: 1.The newly diagnosed T2 DM patients were divided into three groups according to the reasons of admission,Active group,that physical examination showed elevated blood sugar and immediately admitted to hospital(14 cases),accounting for14.29% of all newly diagnosed T2DM;Incompetent group,that is,physical examination or diagnosis of other diseases not found in time for treatment of elevated blood sugar,complications after hospitalization(72 cases),accounting for 73.47%;Passive passive group,that is,do not know their own blood glucose,only clinical complications as the first diagnosis of admission(12 cases),accounting for 12.24%.Most patients do not care about or understand the clinical symptoms of their own,did not receive diabetes-related education,treatment is not timely and delayed treatment timing.2.Among the newly diagnosed type 2 diabetic patients,60 were male and 38 were female,with more men than women;The level of TG,UA and SCr in male was higher than that of women,and the level of HDL was lower than that of women.The difference was statistically significant(P< 0.05),there were no significant differences in Hb A1 c,FPG,CHOL,LDL,ALT,AST,HOMA-RI and BMI(P> 0.05);There was no significant difference in the clinical symptoms of newly diagnosed T2 DM patients(P > 0.05),however,on the whole,people are drunk and tired,and those who are weak occupy a large proportion;The proportion of men's history of tobacco and alcohol is obviously higher than that of women.The difference of TG and HDL between different sexes is related to the history of tobacco and wine;Male UA was negatively correlated with Hb A1c(r =-0.372),female UA,SCr was negatively correlated with Hb A1c(r =-0.521,r =-0.579).3.When the initial diagnosis of T2 DM patients with serum aminotransferase levels in the normal range,male ALT was positively correlated with TG and HOMA-IR(r = 0.332,r = 0.434),AST and TG,HOMA-IRwas also positively correlated(r = 0.275,r = 0.497);There was a significant positive correlation between female ALT and CHOL and LDL(r = 0.525,r = 0.515).There was a positive correlation between AST and CHOL and LDL(r = 0.432,r = 0.514),there was no correlation between ALT and AST in different genders(P > 0.05).4.The patients were divided into young group(18-44 years old),middle aged group(45-59 years old)andelderly group(?60 years old),the levels of TG,HOMA-IR and BMI in young group were higher than those in middle-aged group and elderly group,the difference was statistically significant(P <0.05),However,no significant difference was found in Hb A1 c,HOMA-?,FPG,CHOL,HDL,LDL,UA and SCr(P > 0.05);The positive rates of family history in youth group and middle age group were significantly higher than those in the elderly group,and the incidence of diabetes was correlated with family history.5.The BMI of newly diagnosed T2 DM patients was positively correlated with HOMA-IR,HOMA-? and TG(r= 0.216,r = 0.213,r = 0.257),there was no correlation with Hb A1 c,CHOL,HDL and LDL(P> 0.05),the level of BMI may affect the occurrence and development of type 2 diabetes.6.According to whether patients have urinary ketone body admission,divided into ketosis onset group and nonketotic onset group,Male patients with ketosis onset were twice as many as women,the incidence of Hb A1 c,FPG,2h PG and TG in ketosis group were significantly higher than those in nonketotic onset group,the difference was statistically significant(P < 0.05);the positive rate of family history of ketosis onset group was slightly higher than nonketotic onset group,but the difference was not statistically significant(P>0.05).7.Statistics the use of insulin in newly diagnosed T2 DM patients with Hb A1 c > 9%or fasting venous blood glucose > 11.1mmol/L and with obvious hyperglycemia symptoms,there was no significant difference in whether insulin treatment was applied among different sexes(P > 0.05);In different age groups,the rate of insulin treatment in the elderly group was higher than that in the young and middle-aged group(P < 0.05).8.In recent 3 years,the department of endocrinology of the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine received the largest number of newly diagnosed type 2 diabetes patients in the month of March(11 cases),October(14cases)and November(11 cases),the smallest number of months concentrated in January(5cases),February(4 cases),December(3 cases),type 2 diabetic patients admitted to hospital without significant seasonal,admission time may be related to the unit examination time.Conclusion:1.There is still a lack of knowledge about diabetes in most social groups and it is nottimely to miss the best treatment opportunity,diabetes-related publicity and education still need to be strengthened.2.Differences in levels of TG,HDL,UA,and SCr among different sexes in newly diagnosed T2 DM patients were correlated with smoking and drinking history and long-term hyperglycemia status.There is a positive correlation between serum transaminase levels and TG and HOMA-IR in men,and there is a significant positive correlation between serum transaminase levels and CHOL and LDL in women.Serum transaminase levels may have some reference value for insulin resistance and metabolic disorders in newly diagnosed T2 DM patients.3.The levels of TG,HOMA-IR,and BMI in the young group were significantly higher than those in the middle-aged and elderly groups.The incidence of youth may be related to high TG levels and high BMI levels,and early onset of diabetes is associated with family history of the patient.4.Positive correlation between BMI and HOMA-IR,HOMA-? and TG in patients with newly diagnosed T2 DM,with increased BMI levels,insulin resistance increases and islet cells secrete insulin.5.Patients with newly diagnosed T2 DM with ketosis have more men than women and are more common in middle-aged men.Hb A1 c,FPG,2h PG,and TG levels in patients with ketosis are higher than those with non-ketotic disease.6.For newly diagnosed T2 DM patients who meet the recommended intensive insulin treatment criteria for the 2013 version of the "Guideline for the prevention and treatment of type 2 diabetes in China"(Hb A1c>9% or FPG>11.1 mmol/L,accompanied by marked hyperglycemia).Higher proportion of elderly patients treated with insulin.7.The number of patients with T2 DM in our hospital has increased year by year in the near 3 years.The trend is relatively stable.There is no obvious seasonality in the time of hospital admission. |
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