A Study Of The Long-term Risk And Influence Factor Analysis Of Albuminuria Of Continuous Subcutaneous Insulin Infusion(CSII)therapy On Newly Diagnosed Type 2 Diabetic Patients

Objective:To investigate the effect of early continuous subcutaneous insulin infusion(CSII)therapy on the long-term risk of albuminuria in newly diagnosed type 2 diabetes patients,analyze the relationship between UACR and oxidative stress,and explore the influence factors of albuminuria.Methods:A total of 583 type 2 diabetes patients who had been newly diagnosed in the department of endocrinology of BeiJing general millitary hospital from January 2000 to January 2008 were collected by using electronic record systerm.These patients were divided into CSII( continuous subcutaneous insulin infusion)group and OHA(oral hypoglycemic agents)group according whether they were treated by CSII.They were followed up from December 2014 to December 2015 to re-evaluate their general clinical data d including BP,HbA1 cTC,TG,HDL-C,LDL-C.At the same time,we use Homeostasis model assessment evaluate their pancreatic function and SOD,MDA were adopted to evaluate their oxidative stress level.Results:3.1The long-term risk of albuminuria of different treatment on newly diagnosed T2 DM at followed3.1.1The general clinical data between the two group when they were first diagnosedThere were no significant differences in gender, age, course, BMI, BP, TG, TC, LDL-C,HDL-C, Homa-IR, Homa-βbetween the two group(P>0.05).In group CSII,the level of HbA1 c was statisticly higher than that of the OHA group(P>0.05).3.1.2The general clinical data between the two group at followed There were no significant differences in course,HbA1 c,BMI,BP,TG,TC,LDL-C,HDL-C between the two group(P>0.05).In group CSII,the level of Homa-IR and UACR was statisticly lower than that of the OHA group.While the level of Homa-βwas statisticly higher than that of the OHA group(P>0.05).3.1.3Comparison of the incidence of albuminuria between the two group at followed The incidence of abnomal albuminuria in CSII group was 18.54%,while the incidence of abnomal albuminuria in OHA group was 28.24%.The incidence of abnomal albuminuria in CSII group was statisticly lower than that of the OHA group(P>0.05).3.1.4Comparison of the level of oxidative stress between the two group at followed The level of MDA in CSII was statisticly lower that of the OHA group,while the level of SOD was statisticly higher than that of the OHA group(P>0.05).3.1.5The correlation between UACR and Oxidative stress Spearman rand correlation analysis showed that the level of MDA in patients was positively related to UACR(r=0.120,P=0.004),while the level of SOD in patients was negatively related to UACR(r=-0.198,P<0.001).3.2The influence factor analysis of the incidence of albuminuria in T2 DM at followed3.2.1Single factor analysis showed that the factors impacting the incidence of albuminuria in T2 DM at followed were age,couse,and BP,blood glucose control(P>0.05).3.2.2Multivariable logistic regression analysis showed that course,hypertension,Hyperglycemia were risk factors of albuminuria,while the level of SOD in patients were protective factor of albuminuria(P>0.05).Conclusion:4.1Early intensive treatment of insulin pump on newly diagnosed type 2 diabetic patients can lower the risk of albuminuria.4.2Early intensive treatment of insulin pump on newly diagnosed type 2 diabetic patients can improve the function of islet for a long time.4.3Multiple factors including hypertension, hyperglycemia,couse and oxidative stress contribute to the occurence and progress of albuminuria.