| Objectives: To investigate the influences of glycaemia,lipimia,C reaction protein,isletβcell function and insulin resistance after temporary continuous subcutaneous insulin injection or multiple subcutaneous insulin injection treatment in newly diagnosed type 2 diabetic patients.Methods: Forty-five patients, between 25-70 years old, with type 2 diabetes mellitus, less than 1 year course of disease, and fasting plasma glucose(FPG) of 9.0–16.7 mmol/L, were divided into two groups randomly according to 1999 diabetes criteria of World Health Organization(WHO): tweenty-eight cases were in continuous subcutaneous insulin injection(CSII) group and seventeen cases were in multiple subcutaneous insulin injection(MSII) group. Patients were treated with CSII or MSII for 2 weeks. Glycated hemoglobin A1c(GHbA1c), triglyceride(TG), total cholesterol(TC) and C reaction protein(CRP) were checked before and 3 months after the treatments. Fasting plasma glucose(FPG), 2-hours postprandial blood glucose(2hPBG), and body mass index(BMI) were checked before and after treatment immediately, and then after 3 months. Meanwhile, they were all carried out the intravenous glucose tolerance test(IVGTT) and insulin releasing test. At last, the values of plasma glucose and insulin at 0 minute, 1st minute, 3rd minute, 5th minute, 10th minute in IVGTT, contrasted first phase insulin release(FPIR), area under curve of insulin from 0 minute to 10th minute(AUCINS 0-10), Homeostasis model assessment-insulin resistance(HOMA-IR) and Homeostasis model assessment-beta(HOMA-β).Results: 1.FPG, 2hPBG, BMI, HOMA-β, FPIR, CRP,AUCINS 0-10,the plasma glucose and insulin of each time point in IVGTT were significantly improved(all p<0.01),HOMA-IR was decreased (p<0.05) in CSII group after 2 weeks treatment. FPG, 2hPBG, HOMA-β, HOMA-IR, FPIR, CRP,AUCINS 0-10,the plasma glucose and insulin of each time point in IVGTT were improved(all p<0.01),BMI and HOMA-IR were descended(both p<0.05) in MSII group after 2 weeks treatment. 2.FPG, 2hBS, GHbA1c, BMI, HOMA-β, HOMA-IR, TC, TG, CRP, FPIR, AUCINS 0-10,the plasma glucose and insulin of each time point in IVGTT were markedly improved(all p<0.01) in CSII group at 3 months after treatment. FPG, 2hPBG, GHbA1c, BMI, HOMA-β, HOMA-IR, TC, TG, FPIR, AUCINS 0-10,the plasma glucose and insulin of each time point in IVGTT were improved(all p<0.05),CRP was descended(p<0.05) in MSII group at 3 months after treatment. 3.There were no difference between the corresponding values in two groups after 2 weeks therapy. 4.The BMI was lower (p<0.05),the FPG was controlled better,the FPIR and AUCINS 0-10 were increased more obviously(all p<0.01) in CSII group at 3 months after treatment than those of MSII group. 5.The time required to substandard plasma glucose was shorter and the incidence of hypoglycemia was lower in CSII group. 6.The value of HOMA-βbefore treatment was correlated negatively with FPG and 2hPBG(r=-0.708,P=0.000 or r=-0.339,P=0.023),it was also correlated positively with FPIR and AUCINS 0-10(r=0.355,P=0.017 or r=0.309,P=0.039). The value of HOMA-IR before treatment was correlated positively with FPG, BMI, TG(r=0.459,P=0.002 or r=0.456,P=0.011 or r=0.287,P=0.029). 7.At 3 months after treatment,△HOMA-βwas correlated negatively with FPG, TG(r=-0.399,P=0.007 or r=-0.155,P=0.032) and the△HOMA-IR was correlated negatively with FPG, BMI(r=-0.219,P=0.033 or r=-0.104,P=0.046). 8.There were tweenty-eight cases who had not used any hypoglycaemic medicine maitained the target glyceamic control at 3 months after treatment.The remission rate was 62%.The patients in remission group had shorter course, higher BMI(both P<0.01), lower FPG and HbA1c levels(both P<0.05) before treatment.Conclusions: 1.Isletβcell function is partially restored and insulin resistance is reduced. Simultaneously, glycaemia, lipimia and inflammatory reaction are improved by short-term intensive insulin treatment in newly diagnosed type 2 diabetic patients. 2.CSII treatment has lower incidence of hypoglycemia, shorter time to normal glycaemic and less insulin using. CSII treatment might be more effective method for newly diagnosed type 2 diabetic patients. |
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