Effects Of Intensive Insulin Therapy On Blood Coagulation In Patients With Newly Diagnosed Type2Diabetes

ObjectiveTo investigate patients with newly diagnosed type2diabetes after intensive insulintherapy on glucose, lipids, pancreatic β cell function and blood coagulation, and tounderstand the correlation between the blood coagulation function and blood glucose，blood lipids，pancreatic βcell function, to explore the occurrence of hypercoagulabilitypossible mechanism and clinical significance.MethodsFifty-six patients of T2DM who were in the endocrinology department of Qian FoShan Hospital and the Zaozhuang hospital of Shandong Zaozhuang Minal corporation,were observed between January2010and January2012.The patients were selected withthe newly diagnosed type2diabetes using intensive insulin therapy.Fifty-six cases in thetwo hospital who attended the health examination were observed.We measured fastingplasma glucose,2hours postprandial glucose,glycosylated hemoglobin A1c, blood lipids,insulin, PT, APTT, INR, TT.All tests were repeated after three months of intensive insulintherapy and having stopped insulin therapy.Calculated pancreatic βcell function【Homaβ=20×fasting plasma insulin/(fasting plasma glucose-3.5)】, insulin resistanceIR【HomaIR=fasting plasma glucose×fasting plasma insulin/22.5】.Analyzed and comparedbefore and after treatment in patients with fasting blood glucose,2hour postprandialglucose, glycated hemoglobin A1c, lipids, PT, APTT, INR, TT, Homaβ, HomaIR,et al,and indicators before and after treatment were compared with normal, untreatedobservation with statistical methods before and after treatment in type2diabetic patientswith normal blood plasma glucose, blood plasma lipids, pancreaticβcell function andcoagulation changes.The coagulation as the dependent variable, treatment of newlydiagnosed type2diabetes before the FBG, PBG, HbA1c, TC, TG, Homaβ, Homa IR as independent variables, multiple linear regression analysis conducted to observe therelevance among the coagulation, blood plasma glucose, blood plasma lipids andpancreaticβcell function.ResultsThe FBG, PBG, HbA1c, TG significantly decreased in patients with newly diagnosedtype2diabetes after intensive insulin treatment, HDL,Homaβ, HomaIR significantlyimproved, PT, APTT, INR prolonged.They were statistically significant (P <0.05).Diabetesgroup compared with the control group before treatment, FBG, PBG, HbA1c,TC,LDL,TGincreased, HDL,Homaβdown, HomaIR increased, PT, APTT, INR shortened significantly(P <0.05).Type2diabetes after treatment compared with normal, FBG, PBG, HbA1c,LDL,TG increased, Homaβdown, HomaIR increased, PT, APTT, INR was significantlyshorter (P <0.05). multiple linear regression analysis conducted, the results showed thatPT correlated with HDL, APTT correlated with TC,INR correlated with HBA1c、FBG andLDL significantly.ConclusionPatients with newly diagnosed type2diabetes present high coagulation status,and the short-term intensive insulin therapy will help to decrease plasma glucose andTriglyceride,improve High density lipoprotein and Homa function index,decrease Insulinresistance index,improve blood clotting function, but unrecovered to normallevels.Coagulation, have the remarkable relevance with blood plasma glucose, bloodplasma lipids, respectively.The reason that Coagulation recovered incompletely may bedue to incomplete recovery of blood plasma glucose, blood plasma lipids, is not fully backto normal on.MeaningType2diabetes is a slow progression of the disease, the incidence of the two mostimportant factors is the islet β cell failure and insulin resistance, pancreatic β cellfunction progressively decreased the incidence and progression of its foundation.The mainhazard is the occurrence of macrovascular and microvascular complications.In type2diabetes in the early intervention treatment of diabetes, preventing and delaying thedevelopment of chronic complications has a very important far-reaching significance.Thisstudy showed that newly diagnosed type2diabetes on early intensive insulin therapy,metabolic control can significantly reduce the high glucose toxicity and lipotoxicity toprotect islet β cell function, increase insulin sensitivity and reverse diabetic condition, which will help to improve blood coagulation, thereby reducing the risk of chronic diseasecomplications, prevent and delay diabetic macrovascular and microvascular diseaseoccurrence and development.