Characteristics Of Non-obese Diabetes Mellitus Patients In China And Efficacy Of Chromium Picolinate In The Treatment Of Newly Diagnosed Type2Diabetes Mellitus In China

Part Ⅰ Characteristics of non-obese diabetes mellitus patients in ChinaObjective To investigate the characteristics of non-obese diabetes mellitus patients in China.Methods From46239subjects, aged≥20years studied in a national diabetes mellitus (DM) epidemiologic survey in2007-2008in China,44198subjects who were not previously diagnosed DM patients were analyzed, divided into4groups according to BMI. In BMI<23kg/m2group, there were15741subjects with normal glucose tolerance (NGT) and607subjects with newly diagnosed DM. The levels of fasting plasma glucose, plasma glucose30min after OGTT, plasma glucose2h after OGTT and serum insulin were tested. Statistical analysis was completed by SUDAAN10.0.Results The prevalence of positive family history, especially sibling history, was significantly higher in subjects with newly diagnosed DM than in subjects with NGT in BMI<23kg/m2group (P<0.01). Waist circumference of subjects with newly diagnosed DM was significantly higher than those of subjects with NGT (73.5cm vs.76.3cm, P<0.01), although there was no significant difference in BMI. Serum insulin30min after OGTT was significantly lower (28.2μIU/ml vs.15.6μIU/ml, P<0.01), while Serum insulin2h after OGTT was significantly higher (18.8μIU/ml vs.24.5μIU/ml, P<0.01) in subjects with newly diagnosed DM than in subjects with NGT. HOMA-IR was significantly higher and HOMA-B was significantly lower in subjects with newly diagnosed DM than in subjects with NGT in BMI<23kg/m2group. HOMA-IR and HOMA-B were both lower in non-obese diabetes patients than those in other BMI groups.Conclusions The positive rate of sibling family history and waist circumference were significantly higher, HOMA-IR was significantly higher and HOMA-B was significantly lower in non-obese diabetes patients than in subjects with NGT in China. HOMA-IR and HOMA-B were both lower in non-obese diabetes patients than those in other BMI groups. Part II Efficacy of chromium picolinate in thetreatment of newly diagnosed type2diabetes mellitus in ChinaObjective To explore the efficacy and influencing factors of chromium picolinate in the treatment of newly diagnosed type2diabetes mellitus in China.Methods A total of84outpatients with newly diagnosed type2diabetes mellitus visiting4hospitals in Beijing were randomly divided into two equal groups:study group receiving chromium picolinate (Tianmaixiaoke Tablet)240mg bid for24weeks (n=42) and control group sitagliptin (Januvia)100mg qd for24weeks (n=42).30persons were selected from people with normal glucose tolerance as normal control group for serum chromium level testing. The levels of fasting plasma glucose (FPG), plasma glucose2h after meal (PG2h) and glycated hemoglobin (HbAlc) were detected before and24weeks after treatment. The serum levels of chromium and insulin were detected.Results Study was completed in76patients. The serum level of chromium was significantly lower in the diabetes group than in the normal control group at baseline (56.31ng/ml±28.23ng/ml vs112.15ng/ml±21.17ng/ml, P<0.01). At24weeks after treatment, the levels of HbAlc, FPG and PG2h decreased while the serum level of chromium increased significantly in both groups. There were11patients with changed HbAlc from baseline (AHbAlc)≥1%in the study group. At24weeks after treatment, HbAlc decreased by1.61%(from8.38%±0.72%to6.77%±0.62%) and serum level of chromium increased by35.14ng/ml in the AHbAlc≥1%group with a low baseline serum level of chromium (36.27ng/ml±18.00ng/ml). Both study group and control group were divided into three subgroups according to baseline serum level of chromium. AHbAlc reduced with the increase in baseline serum level of chromium in study group, while in control group,△HbAlc was unrelated with baseline serum level of chromium. At24weeks after treatment, insulin resistance index (HOMA-IR) reduced, p cell function index (HOMA-(3) and insulinogenic index (IGI) increased in both groups. Multiple linear regression showed that the variables significantly associated with AHbAlc were baseline HbAlc and the baseline serum level of chromium.Conclusion Chromium deficiency is common in newly diagnosed type2diabetes patients in China. HbAlc decreases and serum chromium increases significantly after chromium supplementation in the patients with a low baseline serum level of chromium.