| Objective: To investigate the short-term intensive treatment of short duration (duration <1year) of type2diabetes (T2DM) using the three anti-diabetic programs including insulin (Ins), oralanti-diabetic agent (OHA) and the combination of insulin and oral anti-diabetic agent (Ins+OHA),observe the changes in islet B-cell function, insulin resistance index, intravenous glucose tolerancetest (IVGTT), and serum lipid levels, evaluate different anti-diabetic programs, reduce insulinresistance, improve the difference in effect of islet function, and provide a basis for the optimizationof treatment of short duration of type2diabetes.Methods: The66cases of patients with less than1year duration of type2diabetes werechosen from our hospital and were randomly divided into three groups, including Ins group, Ins+the OHA group and OHA group, for intensive anti-diabetic control. As the blood glucose controltargets, the peripheral fasting blood glucose level of not greater than6.0mmol/L and the2-hpostprandial blood glucose level of not greater than8.0mmol/L shall be achieved at7-10d, and bemaintained for about two weeks. The changes in fasting plasma glucose (FPG) and glycosylatedhemoglobin (HbA1c), blood lipid, IVGTT, first-phase insulin secretion, insulin resistance index(Homa A) and insulin secretion index (Homa B) before and after treatment were compared amongthe three groups.Results:1. After the treatment using the three different groups of anti-diabetic program, the FPG levelwas significantly decreased than before. There were significant differences (P <0.01) among the Insgroup (9.3±0.69mmol/L to6.3±0.43mmol/L), the Ins+OHA group (10.9±0.63mmol/L to6.7±0.30mmol/L) and the OHA group (9.8±0.65mmol/L to6.9±0.56mmol/L), which was notstatistically significant, P>0.05.2. Among the three different groups of anti-diabetic program, the HbA1c levels of the Ins group and the Ins+OHA group were significantly decreased after treatment than before, so the Insgroup (10.8±0.52%to9.1±0.53%), and the Ins+the OHA group (10.6±0.34%to9.4±0.31%)were statistically significant before and after treatment (P <0.05), and the OHA group was notstatistically significant before and after treatment (P>0.05).3. Among the three different groups of anti-diabetic program, the Homa A level of the Ins+OHA group was decreased after treatment (5.46±0.47to3.12±0.28), the Homa B level wasincreased than before (39.18±5.41to82.02±8.27). There was significant difference (P <0.01). Thedifference between the Ins group and the OHA group was not statistically significant (P>0.05)before and after treatment.4. Among the three different groups of anti-diabetic program, the TG, TC and LDL-C levelsof the Ins group and the Ins+OHA group were decreased than before treatment, and the differencebetween the two groups was statistically significant (P <0.05), and the difference of the OHA groupbefore and after treatment was not significant (P>0.05).5. Among the three different groups of anti-diabetic program, the IVGTT test showed that theblood glucose levels were significantly decreased, which was statistically significant (P <0.05); withthe decrease of blood glucose drops, the three groups of serum insulin levels and the insulin areaunder the curve were significantly increased, which was statistically significant (P <0.05). Thecomparison among the three groups was not statistically significant (P>0.05).Conclusion:1. After the treatment of intensive treatment of the patients with short duration of type2diabetes using the three different groups of anti-diabetic program, the FPG level was significantlydecreased than before; the HbA1c and blood lipid levels of the Ins group and the Ins+OHA groupwere improved significantly; the islet B-cell function and insulin resistance after intensive treatmentof the Ins+OHA group were significantly improved; the IVGTT test showed that, after thetreatment of the three groups, the serum insulin levels and the insulin area under the curve wereincreased, and the first-phase secretory function of pancreatic B cells were significantly improved.2. All the three intensive treatment programs can significantly lower blood glucose level, andimprove the islet B-cell function and insulin resistance at different levels, but there are no significantdifferences among the three groups. |
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