| Objectives: To observe the influence of different therapies (glipizide,pioglitazone, insulin)on the function of type 2 diabetic patients'platelets. Methods: 60 recent diagnosed type 2 diabetic patients who had been treated ineffectively with Metformin were divided randomly into three groups:Group A: it refers to Group of Glipizide,which means to add glipizide(5-10mg/day) on the former treatment of Metformin(1.5g/day);Group B: it refers to Group of Pioglitazone,which means to add pioglitazone(15-30mg/day) on the former treatment of Metformin(1.5g/day);Group C:it stands for Group of Insulin-injection,which means to add insulin injection( with individualized dosage) on the former treatment of Metformin. Besides, to set up a Group R: this group consists of 20 newly diagnosed type 2 diabetic patients, and to give this group of patients intensified therapy with insulin. Group N: 20 matched healthy control subjects. At the beginning of the study, FBG, HbA1C, expression ratio of GMP-140,PAC-1 on the platelet membrane, and the packing fraction of the platelets derived by ADP were measured in all the subjects. Two weeks later, we detected variables above mentioned in Group R, and compared the result with the index detected in week 0 on the theory of statistics. In addition, the platelet activation of group A, group B, and group C were measured in week 4 and week 24, and compared with the results inspected in week 0 separatly, as well as to make comparison among group A, group B, and group C.Results:①On the baseline, there no significant difference among group A, group B and group C's FBG,HbA1C, their packing fractions of the platelets derived by ADP, and their express ratios of GMP-140,PAC-1 on the platelet membrane(P﹥0.05).②At the baseline, FBG,HbA1C, its packing fraction of the platelets derived by ADP, as well as its express ratio of GMP-140,PAC-1 on the platelet membrane in group R were all obviously higher than those in Group N , and those differences were statistically significant(P﹤0.01).③Two weeks after been treated, group R's FBG,the packing fraction of the platelets derived by ADP, and the express ratio of GMP-140,PAC-1 on the platelet membrane are lower than those on the baseline,as well, with a statistical significance( P〈0.01).④Four weeks after been treated,the differences of FBG between group A and group C has no statistical significance(P﹥0.05), the FBG of group B was higher than that of group A and group C with a statistical significance: P﹤0.01.⑤Four weeks after been treated, the differences of the packing fraction of the blood platelets derived by ADP, and the express ratio of GMP-140,PAC-1 on the platelet membrane had no statistical meaning (P>0.05) among group A, group B and group C.⑥24 weeks after been treated,the differences of FBG,HbA1 between group A and group C had no statistical significance(P﹥0.05),the FBG in group B was higher than that of group A and group C, with a statistical significance of P﹤0.01, the HbA1C was also higher than that in group A and group C, the difference had statistical meaning(P〈0.05〉.⑦24 weeks after been treated,the difference of the packing fraction of the platelets derived by ADP and the express ratio of GMP-140,PAC-1 on the platelet membrane between group A and group C had no statistical meaning(P﹥0.05). The packing fraction of the platelets derived by ADP in group B was lower than that in group A and group C, with a statistical significance of P﹤0.01, the expression ratio of GMP-140 of group B was lower than that of group A and group C, with a statistical meaning of P﹤0.05, and expression ratio of PAC-1 in group B not only lower than that of group A(P﹤0.01),but also lower than that of group C(P﹤0.05).Conclusion Different anti-diabetes therapies can cut down the blood glucose, at the same time; they can supress the platelet function of type 2 diabetic patients. What's more, the Pioglitazone is more effective than the Glipizide and Insulin in lowering enhanced platelet function; which is independent of its effect on lowing blood glucose. |
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