Insulin Sensitizers And Insulin Secretion Promoting Agents Suitable For Which Type 2 Diabetic Patients?

Objective To observe improvement of glucose control andβ-cell function in type 2 diabetes patients after long-term use of metformin insulin sensitizers or insulin secretion promoting agents.Methods An retrospective non-randomised concurrent control research methods were adopted in this study.107 outpatients with type 2 diabetes who regularly follow up more than 1.5 years were chosen from diabetic clinical pathway management system in our department. These patiens were divided into two groups according to their medication and body mass index (BMI), metformin plus insulin sensitizer treatment group with BMI>24 kg/m2 (Group A), and metformin plus insulin secretion promoting agents group with BMI<24 kg/m2 (group B). Fasting blood glucose (FBG),2 hours postprandial blood glucose (2hPBG), glycosylated hemoglobin Alc (HbAlc), fasting insulin (FINS),2 hours postprandial insulin (2hINS),serum lipids (TG,LDL-c, and HDL-c), HOMA-IR, HOMA-IS, and HOMA-IAI were analyzed between baseline and after follow-up and between groups.Results Compared to baseline, the levels of FPG.2hPBG,HbAlc were decreased significantly in both group A and B (P<0.05). The rate of good HbA1c control (HbA1c value<6.5%) were significantly increased (70.37% vs 55.5% in group A,65.96% vs 48.94% in group B, respectively). HOMA-IAI were significantly increased (P<0.05) while HOMA-IR decreased (P<0.05) in group A. HOMA-IAI and HOMA-IS were significantly increased while HOMA-IR decreased (P<0.05-0.01) in group B. HOMA-IAI increased more obvious in group B compared to group A.Conclusions Selection of insulin sensitizer or insulin secretion promoting agents according to cut-point of BMI 24 could obviously ameliorated glucose control, increased goal attainment rate of HbAlc,and improved islet function in type 2 diabetic patients.