Metformin In Therapy For Patients With Newly Diagnosed Type 2 Diabetes And Impaired Glucose Tolerance

ObjectiveObservation of the change of plasma glucose, glycosylated hemoglobin(HbA1c), blood lipid, blood pressure, body mass index(BMI), waist hip ratio(WHR), uric acid(UA), plasma adiponectin and plasma visfatin after one year therapy of Metformin on patients with newly diagnosed type 2 diabetes(T2DM) and impaired glucose tolerance(IGT). To investigate the curative effect of Metformin on T2DM and IGT patients with lifestyle intervention while Metformin treatment efficacy.MethodNewly diagnosed T2DM, IGT patients with 30 cases, 30 cases of healthy volunteers, respectively, as T2DM group, IGT group and normal control group, and compared the differences of plasma glucose, HbA1c, blood lipid, blood pressure, BMI, WHR, UA, plasma adiponectin and plasma visfatin levels in each group. All the T2DM group and IGT group patients were given rational diet according to the difference of individual gender, height, weight, labor intensity and exercise on an average of 30 min/d which was not less than 150 min per week while Metformin was administrated at the dose of 1500mg/d. Six month later, after the detection of FPG, 2hPG and HbA1c, those who reached the targets ajusted to 1000mg/d. After measuring 2hPG in T2DM group, the patients who did not reach the targets were added acarbose three times daily, 50 mg every time. The changes of the indexes mentioned aboved were detected after one year. Plasma adiponectin and visfatin levels were assayed by ELISA. Blood total cholesterol(TC), triglyceride(TG), high-density lipoprotein cholesterol(HDL-c), low-density lipoprotein cholesterol(LDL-c), UA were detected by automatic biochemistry apparatus. Fasting plasma glucose (FPG), 2h plasma glucose (2hPG) were assayed by glucose oxidase method. HbA1c was detected by high pressure lipid phase method.Result(1)Compared with control group, BMI, systolic blood pressure(SBP), TC, FPG, 2hPG and HbA1c were significantly higher in T2DM group (P<0.01 or P< 0.05) , BMI, TC, FPG, 2hPG and HbA1c were increased significantly (P<0.01 or P<0.05) in IGT group, while adiponectin and visfatin levels were significantly lower (P<0.01, P<0.05) . T2DM group of FPG, 2hPG, HbA1c was significantly higher than IGT group (P<0.05) .(2) In IGT group, BMI, WHR, LDL-c, TC, FPG, 2hPG were significantly reduced (P<0.01 or P<0.05) , plasma adiponetin level was significant increased (P<0.05) after therapy. SBP, diastolic blood pressure(DBP), TG, HbA1c decreasd and HDL-c, plasma visfatin levels were higher than before, but the differences were not statistically significant. In T2DM group, BMI, WHR, TC, FPG, 2HPG, HbA1c were also significantly lower (P<0.01 or p<0.05) and plasma adiponectin level was significantly higher after therapy (P<0.01) . The changes of SBP, DBP, TG, HDL-c, LDL-c, UA, plasma visfatin level were not statistically significant before and after.Conclusion(1) Patients with T2DM often accompanied by obesity and dyslipidemia. The study found that BMI, TC, blood glucose, HbA1c were significant higher in patiets with T2DM and IGT while plasma adiponectin and visfatin levels were significant lower compared to healthy control group.(2) Metformin can reduce blood glucose, HbA1c, BMI, WHR, elevate plasma adiponectin and visfatin levels and improve the body lipid metabolism in patients with T2DM and IGT.(3) The intervention treatment with Metformin is effective for newly diagnosed T2DM and IGT while lifestyle modification is managing.