| Objective:Diabetes(DM) is a group disease characterized by chronic high blood sugar, accompanied by disorder of carbohydrates, fat and protein metabolism. With economic development, people's lifestyle changes and an aging population, DM showed a rising incidence trend, and had become a serious threat to human health. Type 2 diabetes accounts for approximately 90 to 95% of all diagnosed cases of diabetes. So protection of isletβ-cell function and improvement insulin resistance will be the key points. Some clinic studies had showed that insulin treatment in T2DM, especially for newly diagnosed T2DM, not only could effectively decrease blood glucose, but also could significantly protect isletβ-cell function and improve insulin resistance. However, for non-onset T2DM, it was not sure of effect of insulin therapy onβ-cell function and insulin resistance. Therefore, this study was to observe the efficacy, safety and effect onβ-cell function and insulin resistance of premixed insulin aspart 30(aspart 30) and premixed human insulin 30R(Novolin 30R) in non-onset T2DM, and to provide accordance for selecting optimization of insulin therapy in patients with T2DM.Methods:60 patients with non-onset T2DM were enrolled to this study. According to the diagnosis and classification standards recommend by WHO in 1999. height and weight were measured, and then body mass was counted. Blood samples were collected to test fasting blood glucose(FPG), glycosylated hemoglobin(HbAlc), fasting C-peptide(FCP), and post oral glucose 2 hours C-peptide(2hCP). Postprandial 2-hour blood glucose (2hPBG) was checked on the same day by blood glucose meter (Roche). Insulin resistance index(HOMA-IR) and pancreatic P cell index(HOMA-β) and area under the curve of C-Peptide releasing (AUC cp) were calculated. After the original treatment was suspended, they were divided into two groups with twice-daily Aspart 30 or Novolin 30R subcutaneous injection. It was allowed to be combined with oral hypoglycemic agents (metformin, acarbose and rosiglitazone). Hypoglycaemic and other adverse events were the chosen safety parameters. The treatment was proceeding at least 3 months. The index was measured again. The data was analyzed.Results:The gender, age, duration of patients in two groups were same, and the baseline level of BMI, FPG,2hPBG, HbA1c, FCP,2hCP, HOMA-IR, HOMA-βand AUC cp120 in two groups was not significantly different(P> 0.05).After treatment, the FPG,2hPBG, HbAlc decreased significantly compared with before treatment(P<0.05).2hPBG of Aspart 30 treatment group was significantly lower than that of Novolin 30R treatment group (P<0.05). but there was no significantly difference in FPG and HbAlc.The incidence of hypoglycemia in Aspart 30 group was lower than Novolin 30R group, but it is not significant difference(P>0.05). After treatment, BMI of patients in Aspart 30 group was no significant difference compared with Novolin 30R group(P>0.05).After treatment, the FCP,2hCP, HOMA-βand AUCcp120 did not have significant change compared with before treatment(P>0.05), and they were not significantly different between two groups(P>0.05). After treatment, HOMA-IR was significantly improved compared with before treatment in each group(P<0.05), but it was not significantly difference between two groups(P>0.05).Conclusions:The high blood glucose were able to achieve significant desease by Subcutaneous injection with aspart 30 or Novolin 30R. Compared with Novolin 30R, postprandial 2-hour blood glucose in aspart 30 group was more significantly reduced, so with can reduce blood glucose fluctuations and the incidence of hypoglycemia. The islet P-cell function of patients with non-onset T2DM was no significant difference by subcutaneous injection with aspart 30 or Novolin 30R, but the insulin resistance was significantly improve after treatment. It was not significantly difference between two groups.
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