The Relationship Between Blood Glucose,Glycosylated Hemoglobin,C-peptide And Diabetic Retinopathy In Newly Diagnosed Patients With Type 2 Diabetes Mellitus

Background & Objective:Diabetes Mellitus(DM)is a chronic metabolic disorder of glucose as the main manifestation. This clinical syndrome is caused by a variety of genetic and environmental factors.At present in China,the prevalence rate of type 2 diabetes increased rapidly, it has surpassed India to become the first country of diabetes. The greatest risk to the patients is the diabetic complications,such as diabetic retinopathy(DR),diabetic nephropathy and so on,they have become very important factors and major concerns that threaten human health. How to predict and delay the progression of chronic complications of diabetes is one of the most important tasks in the treatment of diabetes. Diabetic retinopathy(DR) is one of the most frequent complications of diabetes,and it is also the major cause of decline of eyesight and blindness among patients with type 2 diabetes.The pathogenesis of diabetic retinopathy are very complicated,with the result of multiple factors.The association between blood glucose metabolism related indexes such as blood glucose,C-peptide and glycosylated hemoglobin with DR in newly diagnosed T2 DM patients remain controversial.This study determined serial plasma glucose, glycosylated hemoglobin and C-peptide levels in newly diagnosed patients with type 2 diabetes mellitus,to investigate the relationship between glucose metabolism related indexes and diabetic retinopathy in newly diagnosed patients with type 2 Diabetes Mellitus,to intervene the risk factors in the clinical treatment of diabetes,diagnose and treatment of diabetic retinopathy,delay its occurrence and development,improve the quality of life in patients with diabetes. MehtodsAccording to the diagnostic criteria of Diabetes Mellitus formulated by the WHO in 1999 and the diagnostic criteria of Diabetic Retinopathy(DR) developed in the third Department of Ophthalmology in 1983 cases were collected and divided into different groups.180 cases newly diagnosed T2 DM patients in the First Affiliated Hospital of Zhengzhou Univercity were collected,to determine the fasting blood glucose, glycosylated hemoglobin(HbAlc),and C-peptide level.All 180 patients underwent standard oral glucose tolerance test,and the postprandial 2 hour glucose,C-peptide level were determined respectively.All patients accepted digital fundus camera screening(some patients cannot be determined by non-mydriatic or mydriatic digital fundus camera screening, fundus fluorescein angiography of eyes were examinationed),and divided into two different groups according to with or without retinopathy and the severity of diabetic retinopathy:134 cases newly diagnosed type 2 diabetes without retinopathy group(referred to as the NDR group) record as A group,29 cases newly diagnosed type 2 diabetes mellitus with background retinopathy group( referred to as the BDR group) record as group B1;17 cases newly diagnosed type 2 diabetes mellitus with proliferative diabetic retinopathy group(referred to as the PDR group) record as group B2.Record the gender,age,height,weight of all patients.When patients admitted to hospital,every three minutes to measure the blood pressure,Measured 3 times,take the average of the three measurements and recorded.Determine the serum electrolytes, alanine aminotransferase(ALT),aspartate aminotransferase(AST),serum total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL-C),low density lipoprotein(LDL-C),blood urea nitrogen(BUN),creatinine(Cr) and other indicators statistical analysis was performed using SPSSl9.0 software.Fasting plasma glucose,postprandial two hour plasma glucose and glycosylated hemoglobin were tested by t-test in groups of A and B.Then the fasting blood glucose(FBG),postprandial plasma glucose(PPG),glycosylated hemoglobin(HbAlc) and C-peptide were segmented to calculate the prevalence of diabetic retinopathy,Observe the association between these indexes and diabetic retinopathy.A level of significance of p value of less than 0.05 was used. Results1. A total of 46 cases(25.56%) newly diagnosed type 2 diabetes were diagnosed with diabetic retinopathy.2. The difference of FCP,The level of 2hPG and HbAlc of group B were higher than group A(P<0.05). The level of FCP of group B was lower than group A(P<0.05). There was no statistical significance ofsex, age and FPG between groups of A and B(P>0.05).3. Segmenting the blood sugar,the incidence of diabetic retinopathy in diabetics whose FPG<8.0mmol/L was lower than whose FPG?8.0mmol/L(P<0.05).4. Segmenting the level of HbAlc,the incidence of diabetic retinopathy in diabetics whose HbAlc?7.0% was lower than whose Hb Alc>7.0%.The level of HbAlc of groupB2 was higher than group B1(P<0.05).5. To analyze of the relative biochemical indicators by logistic regression methods,in which 2hPG and HbAlc were positively correlated with the incidence of diabetic retinopathy, FCP level was negatively correlated with the incidence of diabetic retinopathy. Conclusion1. Serum C-peptide levels may have important significance in the incidence and severity of diabetic retinopathy.The decreased serum C-peptide levels may be considered a significant clinical maker of diabetic retinopathy in newly diagnosed type 2 diabetes.2. It shows that 2hPG and HbAlc are the risk factors of diabetic retinopathy in newly diagnosed type 2 diabetes.