Effect Of The First Short-term Intensive Insulin Therapy On Iron Metabolism In Patients With Type 2 Diabetes Mellitus

Objective:The type 2 diabetes mellitus is the most common classification of diabetes,the prevalence is increasing annually,and the patients of type 2diabetes mellitus tend to be younger.Its chronic and acute complications seriously threaten the patients'health,longevity and quality of life.At the same time,the annual medical expenditure for the treatment of type 2 diabetes and its complications is huge,in China,and it is an arduous task for us to prevent and treat type 2 diabetes.This study was designed to investigate the change of indicators of iron metabolism in the patients with type 2 diabetes mellitus after short-term intensivie insulin therapy firstly,and the correlations were analyzed between the indicators of iron metabolism and the common clinical indicators.For the patients of type 2 diabetes mellitus,the attention should be paid to the indicators of iron metabolism in clinical work,which can explore new ideas and direction for preventioning type 2 diabetes mellitus,and provide referrence for the discovery of new therapeutic targets.Methods:A total of 120 cases diagnosed type 2 diabetes mellitus and admitted to the endocrinology department of Chengde Central Hospital from August 2017to January 2019 were collected,the patients were eligible for the study.The basic information of patitens'sex,age,body mass index(BMI),disease duration were recorded.The indicators of serum iron(SI),serum ferritin(SF),fasting plasma glucose(FPG),fasting C peptide(FCP),glycated hemoglobin(HbA1c),triglyceride(TG),total cholesterol(TC),hepatic and renal function,blood routine were tested.The patients were given intensivie therapy of continuous subcutaneous insulin infusion for seven to fifteen days.The levels of SI,SF,FPG,FCP were retested after treatment.Homeostasis modle assessment of islet beta cell function index(HOMA2-%B),Homeostasis modle assessment of Insulin resistance index(HOMA2-IR)were calculated by the homeostasis model assessment 2 calculator before and after therapy,further,the differences of SF,SI,FPG,HOMA2-%B,HOMA2-IR were calculated(the values of pre-therapy minus post-therapy).The values of SI,SF,FPG,FCP,HOMA2-%B,HOMA2-IR before and after treatment were compared.Before treatment,the correlations of SI,SF and FPG,HbA1c,TG,TC,HOMA2-%B,HOMA2-IR were analyzed by Pearson or Spearman correlation analysis.Further correlations of serum ferritin difference(?SF),serum iron difference(?SI)and disease duration,fasting plasma glucose difference(?FPG),HOMA2-%B difference(?HOMA2-%B),HOMA2-IR difference(?HOMA2-IR),BMI were analyzed.P<0.05 was considered statistically significant.Results:1 General information and clinical indicators of the patientsThere are 66 males and 54 females in the sdudy.the age was(54.21±10.85)years,the level of HbA1c was(10.51±1.40)%,significantly higher than normal level,TG(1.90±0.60)mmol/l,TC(4.48±1.12)mmol/l,BMI(23.20±1.81)kg/m~2,The course of disease was(4.39±2.11)years,and 72cases with fatty liver.2 The Comparison of SI,SF,FPG,FCP,HOMA2-IR and HOMA2-%B before and after intensive treatment.Compared with pre-treatment,the levels of SI,SF,HOMA2-IR,FPG were decreased,the difference was statistically significant(P<0.05),the level of FCP was decreased,but there was no significance(P>0.05).HOMA2-%B was improved,the difference was statistically significant(P<0.05).3 Correlation analysis of SI,SF and FPG,HbA1c,HOMA2-IR,HOMA2-%B,TG,TC before treatment.The level of SF was positively correlated with HbA1c,HOMA2-IR and TG before treatment(P<0.05).The level of SF has no correlation with FPG,HOMA2-%B and TC(P>0.05);The level of SI was positively correlated with HbA1c(P<0.05),there was no correlation with other indicators(P>0.05).4 Correlation analysis of?SF,?SI and disease duration,?HOMA2-IR,?FPG,?HOMA2-%B,BMI.?SF was negatively correlated with disease duration(P<0.05),and positively correlated with?HOMA2-IR,?FPG(P<0.05),and there was no correlation with?HOMA2-%B,BMI(P>0.05).?SI has no correlation with disease duration,?HOMA2-IR,?FPG,?HOMA2-%B,BMI.Conclusion:The short-term intensive insulin therapy for the first time can correct hyperglycemia,improve insulin resistance and function of islet beta cell,and reduce the levels of SI and SF in patients with type 2 diabetes mellitus.and the levels of SI and SF are correlated with the degree of blood glucose and insulin resistence,etc.The decrease of SF is related to the improvement of insulin resistance and the lower blood glucose after intensive therapy,which provides a new therapeutic target for the treatment of type 2 diabetes.