Effects And Possible Factors Analysis Of Standardized Management On Thyroid Function In Patients With Type 2 Diabetes

Objective:Through collecting clinical basic information of the patients with type 2diabetes,I have a debate on the patients with type 2 diabetes.In this paper I discuss that the impact of blood glucose improvement on thyroid function and the possibleinfluencing factors produced by blood glucose improvement after standardizedmanagement on the patients with type 2 diabetes.This research finally aims to provide a more comprehensive reference for the patients with type 2 diabetes,and helps thepatients to reduce the incidence of thyroid abnormalities.Methods:?1?A total of 236 patients with type 2 diabetes who were hospitalized in the Third Department of Endocrinology,Liaoning Provincial People,s Hospital fromSeptember 2016 to December 2019 were collected in this research.We have kept records of blood glucose and thyroid function indicators and some other indices of these selected patients when they were admitted to hospital the first time.Blood glucose indicators include fasting blood glucose?FPG?,2 hours postprandial bloodglucose?PPG?,and glycated hemoglobin?Hb Alc?.Thyroid function indicators include free triiodothyronine?FT₃?,free thyroxine?FT₄?,and thyroid stimulating hormone?TSH?.And other indices include gender,age,triglyceride?TG?,cholesterol?CHO?,high density lipoprotein?HDL?,low density lipoprotein?LDL?,blood uric acid?UA?,alanine aminotransferase?ALT?,aspartate aminotransferase?AST?,blood creatinine?Cr?,blood urea nitrogen?BUN?,systolic blood pressure?SBP?,diastolic bloodpressure?DBP?etc.?2?The selected patients were divided into a standard management group of 118 people and a conventional treatment group of 118 people.The two groups of selected patients were treated separately according to the corresponding scheme,and the selected patients were followed up at regular intervals.After 6 to 24 months,onaverage of?12.07±4.35?months,the patients were collected the correspondingindicators and indices again.The results are analyzed by using statistical software.The corresponding indicators between the two different groups and in each group beforeand after management are compared to find out the relationship.Results:?1?At the time of enrollment,there were no significant differences in age,gender,blood pressure,blood lipids,liver and kidney function between the standard management group and the conventional treatment group.Blood glucose indicatorswere FPG[?9.72±3.66 mmol/L?vs?9.15±3.28 mmol/L?],PPG[?13.41±4.85 mmol/L?vs?13.47±4.69 mmol/L?],and Hb Alc[?8.23±1.87%?vs?8.30±1.84%?],and thyroid function indicators were FT₃[?3.04±0.38 pg/m L?vs?3.07±0.36 pg/m L?],FT₄[?1.29±0.19 ng/d L?vs?1.26±0.19 ng/d L?],and TSH[?2.08±1.09?U/m L?vs?2.03±1.12?U/m L?].There were also no significant differences between these two kinds of indicators?both P>0.05?.?2?After follow-up:?1?Glycemic-related indicators:The follow-up indicators of the standardized management group were significantlylower than when they were enrolled.The results were:FPG[?7.82±2.32 mmol/L?vs?9.72±3.66mmol/L?],PPG[?9.56±2.62 mmol/L?vs?13.41±4.85 mmol/L?],and Hb Alc[?7.39±1.32%?vs?8.23±1.87%?].All these indicators were statisticallysignificant?P<0.01?,and lower than in the conventional treatment group,whose results were:FPG[?7.82±2.32 mmol/L?vs?9.27±3.38 mmol/L?],PPG[?9.56±2.62mmol/L?vs?12.78±3.92 mmol/L?],and Hb Alc[?7.39±1.32%?vs?8.17±1.55%?]which were statistically significant?P<0.01?.The indicators of FPG,PPG,and Hb Alc in the conventional treatment group had no significant changes before and after follow-up,and there were no statistical significance?all P>0.05?.?2?Thyroid function indicators:After the follow-up comparison,the FT₃value of the standard management group?3.11±0.46pg/m L?was higher than that of the conventional treatment group?2.79±0.42pg/m L?,and was statistically significant?P<0.01?.But FT₄,TSH were not statistically significant?both P>0.05?.FT₃,FT₄and TSH were not statistically significant in thestandard management group before and after follow-up.FT₃value after follow-up[?3.07±0.36 pg/m L?vs?2.79±0.42 pg/m L?]in the conventional treatment group was lower than when the patients enrolled,and it was statistically significant?P<0.01?;FT₄,TSH were not statistically significant?both P>0.05?.?3?Other indices:Afterfollow-up,the TG value of the standardized management group decreased compared with the time of enrollment.The result was?2.15±1.46mmol/L?vs?2.22±1.38mmol/L?,and the change was statistically significant?P<0.05?.The SBP,CHO,and LDL in the conventional treatment group after follow-up were higher than when they were enrolled.The results were:[?144.86±20.02 mm Hg?vs?138.96±20.43 mm Hg?],[?5.03±1.27 mmol/L?vs?4.86±0.98 mmol/L?]and[?3.10±0.94mmol/L?vs?2.95±0.78mmol/L?],and the changes were statistically significant?all P<0.05?.HDL in the conventional treatment group decreased after follow-up compared with the time of admission The result was?1.09±0.33 mmol/L?vs?1.14±0.35 mmol/L?,which was statistically significant?P<0.01?.DBP,UA,ALT,AST,Cr,and BUN were notstatistically significant?all P>0.05?.There were no statistical significances in the indicators after management between the standard management group and theconventional treatment group?all P>0.05?.Conclusions:?1?The blood glucose level of patients with type 2 diabetes can be effectively improved through standardized management.?2?Poor control of blood glucose levels may lead to a decline in FT3 levels and increase the prevalence of thyroid abnormalities as well.